Questions about office visits with...

cvzzz

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I am trying to find out the correct way to apply E/M (office visits) for Orthopaedic specialist with:

Injections and Fracture care. I have been told that it depends on what the patient is coming in for. If we know and schedule the patient to come in for injections and fracture care, then we would not bill the E/M (office visit) code. In these cases we would just bill the injection or the fracture care.

Is that the correct way? Does anyone have any information or resources they could share with me on this subject?

Just let me know.

Thanks!
 
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Billing Coordinator (orthopedic office)

You can bill the e/m once with in the first 90 days of the global period with fx care and injections. If the patient comes back for a new complaint with the the global period, you are able to bill another e/m code. just make sure everything is documented in the chart.
 

cvzzz

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Thanks!

I understand what you are saying but I have been to several seminars and I am taking a refresher course thru OSMA/AAPC and from what I am understanding on this issue is that if we know ahead that the pt is coming in for a fracture or if it has already been confirmed to be a fx that we are cautioned to bill the E/M with the fracture fee as well as if we know ahead of time that the pt is coming for the injection we should not be billing the office visit just the injection and medication.

The information I am getting is coming from am auditor's point of view.

Any further thoughts, suggestions, coments?

Thanks again!
 

mitchellde

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That is the way I have always understood it to be. If the fracture has already been confirmed then the evaluation the ortho physician is performing is the essential evaluation necessary for the fracture care, same for the injection. If the provider documents the evaluation of other areas of injury in addition to the fracture then an E&M could be charged.
 
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