Wiki Office visit E/M with modifier and splint application

[JennyPie]

Scenario:
New patient, fell off a swing, our physician orders an x-ray, it was determined there was a buckling fracture of the distal radius. Our tech applies a long arm volar (plaster) splint. The visit meets a level 3. Since the physician performed a work up of this extent and it was decided to apply the splint as a result of the findings is this considered a separately identifiable procedure? Would we be able to bill the E/M w/modifier and splint application together? Our office doesn't currently bill for the supplies.

I know we can bill the splint, just not sure if this warrants a modifier -25 to the E/M so we can capture both.

 

[brendalewing]

Is your doctor Orthopedic? Why not bill for fracture code? 25600 Closed treatment of fx w/o manipulation... and not bill office visit.

 

[nyyankees]

Scenario:
New patient, fell off a swing, our physician orders an x-ray, it was determined there was a buckling fracture of the distal radius. Our tech applies a long arm volar (plaster) splint. The visit meets a level 3. Since the physician performed a work up of this extent and it was decided to apply the splint as a result of the findings is this considered a separately identifiable procedure? Would we be able to bill the E/M w/modifier and splint application together? Our office doesn't currently bill for the supplies.

I know we can bill the splint, just not sure if this warrants a modifier -25 to the E/M so we can capture both.

Yes on 25 modifier. If you report Global fracture code I would still use the level 3 E/M and append 57 modifier. It' a new patient and the doc should report the E/M.

 

[jcbritton]

http://www.aaos.org/news/aaosnow/jul08/managing2.asp

This may be helpful, it's a great article.