Wiki Splint help

[taurus7694]

Can anyone help me with a situation involving Slint application? Pt was seen in ER, determined to have fracture and was splinted in the ER. Pt was then seen in our Orthopedic Clinic where we removed the splint....placed them back into another splint and the decision was made to proceed with ORIF. This ORIF was not done until almost a week later, so how should we bill our office visit in which we splinted the patient. Thanks for any advice.

 

[dmaec]

I'd code it as an E/M (what ever level is supported by documentation) with a splint application code. AND I'd modify the E/M due to the splint application procedure. The fracture treatment code would be used when the ORIF was done, the definitive treatment(and the global period initiated at that time).

others might code it differently......

*nods in agreement with mbort - modifier 25 on the E/M (meant to put that before)*

 

[mksmith713]

I'd modify the appropriate the E/M code with a 57 (decision for surgery) and use the CPT and HCPCS codes for the splint.
CPT 29125 and HCPCS Q-4022 for short arm splint fiberglass adult age 11+
If you use a plaster splint instead of fiberglass, use Q-4021 instead of Q-4022.

 

[mbort]

The 57 modifier is only for use when a decision for surgery is made within 24 hours of surgery so that would not be appropriate. If you are coding out the application of the splint with the E/M, 25 would be the more appropriate modifier.

Mary, CPC,COSC

 

[mksmith713]

mbort, you're right on the money.
I didn't absorb the original post.

 

[taurus7694]

Thank you to everyone...that is what we thought, but just needed reassured!

 

[mksmith713]

How did you end up coding the entire visit?