Wiki Fracture care vs E/M

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LLRodgers

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Hello,

Can anyone help me know if you have a patient who comes in with multiple injuries Ex: fractured wrist, ankle sprain.

1 - Can you code the fracture with a fracture care code and the ankle sprain with an E/M code? I was told that I should code an E/M code for this one.

2 -Also if they have 2 fractures can you code 2 fracture care codes or just one? I was told that if 2 fractures you code only 1 fracture care code

Thank you,
LLR
 
1. Assuming the documentation for the sprain is separately supported, I would bill the E/M. Make sure you are adding appropriate modifiers.
2. When you say they have 2 fractures, are you talking about the radius and ulna, or two different areas? There may be a combination CPT for the radius and ulna, depending on the type of fracture and treatment. In most circumstances for both bone forearm fractures, one treatment is resolving both fractures so only one code is billed.
 
Code all the Dx but as Iowagirl prefaced, if both radius and ulna are fractured and a procedure was deemed necessary, the single CPT code for that area would apply. Assuming both fractures were distal, then your office probably did a short arm cast 29075. Assuming that this was all on the same visit, you could billed office visit with 25 modifier and CPT procedure code with appropriate laterality.

Peace
@_*
I bet you knew this already.
 
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