fracture/no follow up

solocoder

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When a patient is diagnosed with a fracture, but not instructed to return for any follow-up visits (no immobilization applied) can global fracture care be billed? And can someone direct me to rules covering that?

Thanks!
 

Orthocoderpgu

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I would never bill out fracture care for a single visit. The physician can choose between office visits or fracture care, whichever is best for the physician. However, you need to be practical as well. Do you really want to upset a patient with a bill for fracture care when they don't have to return? Since fracture care has a 90 day global, this really should not be billed unless you are going to follow the patient to make sure that the fracture heals in place. Otherwise, bill an office visit. You don't need to upset your patients.
 

solocoder

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Thank you for your reply Orthocoderpgu.
That was my thinking too, but kind of hoping, too, for a "rule" to back me up when I break it to the doc.
 

Orthocoderpgu

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http://www2.aaos.org/bulletin/jun02/cod.htm

Here is some advice from AAOS & CMS.

Your not going to find anything that specific on fracture care. Can your doc bill fracture care when they are going to see the patient only once? Technically yes. But according to this, the key is "intent". If the providers intent is to see the patient only once, fracture care is not appropriate according to AAOS.
 
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