Wiki Fracture care - Peds Doctor

[limit006]

I'm new to coding and confused and I work for a Peds Doctor. How do you decide to bill only for the fracture code and not the E/M? how much of an examine does the Doctor have to do to bill for both e/m and fracture? According to the 1995 guideliness.

Help is most appreciated

Sincerely,
Confused Coder

 

[Lisa Bledsoe]

The doctor can choose to charge either the fracture care OR the E/M - not both. I would base it on the fracture and if the patient will be returning for follow up since these codes have 90 day global periods. Personally, I would code an E/M for something like a simple finger, but fracture care for a wrist...