Fractures

LLRodgers

Guru
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173
Location
Dayton, PA
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Hello,

Can anyone clear up for me when you us a Fracture Care Code and when to use an E/M code?

I know that is they are going to have surgery then I use an E/M Code

If they got to the ER and they are put in a sling and come to us for follow up and we just keep them in a sling and no restorative treatment I code an E/M code.

If a person comes in to the office the first time for pain in the foot that she has been having for two weeks and did nothing about it and we give a diagnosis of Occult fracture would you code a fracture care or an E/M code.

Even finger and toe fractures do you code a fracture care or E/M

Any help in guiding me to the right way to code fractures would be very much appreciated.

Thank You,
LLR
 

tammy roach

Contributor
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When a fracture code is billed, it carries a 90 day global. If the doctor knows this is a one time visit, only an E&M code should be billed.
 

kwebsteranalyst

Contributor
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When you are seeing the patient for the initial visit, you can code the E/M with -25 modifier if you are billing fx care on the same day. You can't bill the E/M for 90 days after that.

If this is their initial visit after being seen at the ER you can still bill the E/M with -25 modifier and bill the fx care on the same day. The ER is not going to be billing the fx care, they are only going to advise patient to follow up with Ortho and put them in something temporary till they see the Ortho for treatment.

Hope this helps.

Karla
 
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