Fracture Care Code with E/M code

[LLRodgers]

Hello,

Can anyone tell me if there is any time or situation where you would code a fracture care code and an E/M code. I was told you use either a Fracture Care Code or an E/M code.

Thank you,
LLR

 

[Orthocoderpgu]

You were told wrong. Think of fracture care the same way you would 20610. Same rules apply. If the patient is seen and your physician identifies a fracture the E/M is supported. Some offices follow the rule that you stated, but that's their choice.

 

[twalls]

You were told wrong. Think of fracture care the same way you would 20610. Same rules apply. If the patient is seen and your physician identifies a fracture the E/M is supported. Some offices follow the rule that you stated, but that's their choice.

But is it also correct if the fracture has already been diagnosed like at the ER, then the patient comes to see the DR. they should only charge the fx care and not the E/M?

 

[Orthocoderpgu]

That can be a bit confusing. It could be, but it would still have to be supported. Don't think of it as fracture care, think of it just as you would 20610 and answer it that way. If a patient comes in with previous X-rays and all your doc has to do is look at them and see the fracture, that would not support an E/M. If that is what is generally happening, then as a general rule the E/M would not be supported.

 

[LLRodgers]

Thank you for the help it is very much appreciated. So are you saying if a patient went to ER and diagnosed with a fracture and sent to orthopedics that that office visit is coded as fracture care.
However if the patient goes straight to the Ortho with hand pain and while there they do x-rays and it is found that that they have a fracture I can code both Fracture Care and an E/M and than any follow up I code the fracture care. I was a little confused on this one.

Again, Thank you any help is appreciated.

LLR

 

[abarruos81]

If the patient was not seen in the ER by our providers, I would bill the E&M with the fracture care code. If the patient was seen in the hospital by our providers, I bill the hospital visit with the fracture care and then future visits in the office fall under global care with the exception of the xrays, splinting, bracing, etc.