Wiki fracture care

cbunti

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I am new to orthopedic coding and I disagree with other office staff on how to bill a fracture. A patient was seen by a PA in the office for a fractured clavicle after hitting a deer the night before. An x-ray was done and he was sent to another facility for a clavicle strap. First I have an issue with the PA seeing the patient and providing the initial plan of care. They state we should bill for closed treatment of the fracture (23500) because there will be other visits for follow up. Would this not be a office visit (99203...)?
 
I am new to orthopedic coding and I disagree with other office staff on how to bill a fracture. A patient was seen by a PA in the office for a fractured clavicle after hitting a deer the night before. An x-ray was done and he was sent to another facility for a clavicle strap. First I have an issue with the PA seeing the patient and providing the initial plan of care. They state we should bill for closed treatment of the fracture (23500) because there will be other visits for follow up. Would this not be a office visit (99203...)?

If this is a new patient then yes you would definitely bill for a new patient office visit. Also, if the doc or PA is planning on seeing this patient again for continued care of this fracture then I would bill example...99203-57, 23500-RT or LT and xray if done in office as well. I don't see why you wouldn't bill for the office visit. and the 57 is because your doing a procedure that carries a 90 day global.
 
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