Slings as fracture care

ercoder65

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Up to this point, I have coded fracture care when the Ortho physician applies a cast/splint to a fracture that he/she manipulates. I have also done so when no manipulation was involved. My question is this: can the use of a sling be considered fracture care so to be able to use one of the 90 day global surgery codes, or is this bundled, minus the supply code, with the E/M code(if performed)? I get conflicting answers and I need someone to advise where I can find any articles on this subject. Our Ortho docs say yes, and the HIM department/Billing department don't feel comfortable with this. Thanks in advance.


Rich:eek:
 

Anna Weaver

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fracture care

Up to this point, I have coded fracture care when the Ortho physician applies a cast/splint to a fracture that he/she manipulates. I have also done so when no manipulation was involved. My question is this: can the use of a sling be considered fracture care so to be able to use one of the 90 day global surgery codes, or is this bundled, minus the supply code, with the E/M code(if performed)? I get conflicting answers and I need someone to advise where I can find any articles on this subject. Our Ortho docs say yes, and the HIM department/Billing department don't feel comfortable with this. Thanks in advance.


Rich:eek:

I had the same concerns with those that involved a sling. I didn't feel comfortable with fracture care until I read the 2009 coding companion orthopaedics spine and above. The one I had so much trouble wrapping my head around was the scapula 23570. The dr. didn't do anything except apply a sling! But, when I read this explanation of code on page 200: "The physician treats a fracture of the scapula bone without surgery or any type of manipulation. X-rays confirm the stable position of the fractured pieces. The physician then places the shoulder in a sling or other brace until the frcture heals."
It goes on to explain the difference of codes 23570-23575. But that's the gist of it. There are other codes that are like this also. No it doesn't seem right to slap a sling on it and call it fracture care. This does, however, carry a 90 day global. So, the office visits following will be in the global.
 
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