Wiki Reusing ED supplies and billing specialist fracture care

jenarnold

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Hello Everyone,
We're having a discussion about the correct fracture CPT coding in an Orthopedic office. We agree that CPT 24530 is correct (Closed treatment of supracondylar or transcondylar humeral fracture, with or without intercondylar extension; without manipulation) for the fracture care. However, we're deliberating over the splint and have queried the provider to clarify if the same splint from the ED was reused and reapplied at the Ortho office or if a new splint was applied. Does anyone know if fracture care is billable if the specialist doesn't provide new supplies but reuses splint given at ED?

A 57-year-old woman slipped and fell landing on her right side. She went to the ED where x-rays confirmed a non-displaced bicondylar humerus fracture. The patient was placed in a posterior long-arm splint at a 45 degree angle with sling. She was discharged with orthopedic follow-up. The ED only charged 99284.

The patient presented to the Orthopedic physician office 2 days later. Impression: 57 y.o. female with right nondisplaced bicondylar humerus fracture of the elbow. Plan: We will plan on treating her injury conservatively. She was placed back into a long-arm splint today. I provided her a referral to occupational therapy to have a removable long-arm splint made, and to begin active/active assist/passive range of motion exercises to the fingers and hand. We will begin gentle active range of motion exercises to the elbow in 2 weeks, and active/active assist/passive range of motion exercises in 3 weeks. I will plan on seeing her back in clinic in 2 weeks time for recheck with repeat x-rays of the elbow out of the splint, AP/lateral/radial head views.
Thank you! Any help is appreciated!
 
The CPT code is not dependent on whether or not the application of the splint is from new or used material. The fracture was still treated and/or evaluated by the physician and the splint was reapplied which meet the requirements for billing this code.

Definition of 24530...

In 24530, a nondisplaced supracondylar or transcondylar fracture of the humerus with or without intercondylar extension is evaluated. A neurovascular exam is performed to ensure that the nerves and blood vessels at the site of the injury are intact. No manipulation of the fracture fragments is required. The arm is initially immobilized using a long arm splint that may be replaced with a cast once any swelling has subsided.
 
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