We generally do not bill an E&M service with a fracture care code. Most of the patients have been seen in the ER and have been diagnosed with a fracture and are seeing the ortho in follow-up. We bill fracture care global code for some fractures and E/M billed out with casting/splinting charges if the fracture is not going to be followed for most of the 90 global period. We have many issues with insurance companies not paying for fracture care that is not casted and/or manipulated. Any help would be greatly appreciated. Thanks!