Wiki Fracture Care pending MRI


Cedar Hill, MO
Best answers
Sometimes a patient comes in with pain and a fracture is not visualized on the x-ray and they are sent for an MRI. If the MRI comes back with a definitive fracture diagnosis, would you bill the fracture care on the initial visit or when they come back in for their first follow up visit? Sometimes the MRI results are discussed over the phone and the patient does not come back for 2-4 weeks for clinical radiographic follow-up and it does not seem right to bill it there either? Please help!! FYI, the treatment plans would be documented within the phone conversations and the planned follow-up visit would be scheduled at that time.

Thank You,
Katherine Ellis C.P.C.
As far as I've ever known, if you know the fracture diagnosis at the time of billing the original visit, you can bill the fracture. If you are billing before you have results back, then you wouldn't put the fracture.

I bill for radiologists, and there are times when they do x-rays and MRIs and don't find the fracture on the plain x-rays. On the x-rays I usually use the a code like S39.92XA for unspecified lumbar injury, with the external code for the injury cause. There is some sort of injury known, just not exactly what yet.

Hope that helps, or someone else has a better answer.
Thank you for your help. We do try to hold them until we get the MRI results back, I just wanted to make sure we were being compliant.

Thank you again