Fracture care - ATV accident

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Hi there! I have a billing question.. Patient came into our office after a ATV accident. He did not go the ER or anywhere else. The Patient Hurt is left arm Dr noted a Distal radial fracture nondisplaced. He did put a Don joy cast on his wrist but the Patient had to be sent out for Xrays since our machine is down. Fracture care is obvious but can u also bill a E/M code? Totally new to all this. Any help would be greatly appreciated.
 

pogiest

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Jacksonville Florida Chapter
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Hi there! I have a billing question.. Patient came into our office after a ATV accident. He did not go the ER or anywhere else. The Patient Hurt is left arm Dr noted a Distal radial fracture nondisplaced. He did put a Don joy cast on his wrist but the Patient had to be sent out for Xrays since our machine is down. Fracture care is obvious but can u also bill a E/M code? Totally new to all this. Any help would be greatly appreciated.
You sure can. You can code a new patient E/M since this is the patient's first time to see you, even though it's for fracture care.
 

CodingKing

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You sure can. You can code a new patient E/M since this is the patient's first time to see you, even though it's for fracture care.
If its just fracture care, being a new patient doesn't automatically mean you can bill an E&M.

Per NCCI:

For major surgical procedures (fracture care is 90 day global, meaning major), an E&M service addressing the decision to perform the surgery is reimbursable on the date of the surgery. That service may be reported with modifier 57, if appropriate. Other preoperative E&M services on the date of surgery are not separately reportable.

For all surgical procedures, other E&M services related to the surgical procedure or to post-operative complications are not separately reimbursable on the day of the surgery and should not be reported.
 
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