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Wiki Fracture coding help

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robbin carrone

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Please help!

Does anyone have a "go to" article for fracture care guidelines? I need to know if Dr. A can bill fracture care in office/ER, then Dr.B (same office/Tax ID) takes the same patient, same fracture to OR next day for ORIF and bill for that surgery.

NCCI states that only one fracture code can be reported for the repair of a fracture or dislocation at an anatomic site.

Thank you
 
You could always reference the "ED Fracture Care Redux" article on page 20 of the March 2015 Healthcare Business Monthly. That gave some really nice examples and rationales of when and when not to bill fracture care codes.

As far as your example is concerned, it doesn't seem like Dr A is providing the restorative care if the same patient is being taken to the OR the next day for an open reduction by a different doctor. I hope the article that I referenced above provides some assistance in this matter.
 
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