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Thread: fracture reduction in ER

  1. #1

    Default hai

    AAPC: Back to School
    If the ER dr reduces the fracture then how come the ortho DR again reduce the fracture in OR , if the document is like that means , may be the ER Dr places the splint or he may try to reduce the # , however the ortho Dr states he reduce the # means we have to code # care for ortho only. for ER we have to code splint , this is my veiw.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default Fracture care

    Fracture care carries a 90-day global period.

    Since your ER physician is NOT going to be doing any follow-up on this case, I would recommend that you code the ER visit and the splinting.

    If the documentation is very clear about reduction/manipulation, then you could code the fracture care with a -54 modifier since you won't be providing any follow-up.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. #3
    Join Date
    Apr 2007
    Duluth, Minnesota


    very nicely stated Tessa! great clarification of services AND reminder of the necessary use of modifier 54 !
    Donna, CPC, CPC-H

  4. #4
    Join Date
    Apr 2007
    Hartford, CT


    our policy is if patient is immediately going to ortho we would never charge fracture managment in the ed. now, if they are going in a few days to follow up esp if our doc did reduce the fracture, we would then charge fracture care. in this case you are always safe to charge a splinting.
    Pat A. Trautner, CCS/CPC/CEDC/CHONC

  5. #5

    Default Fracture question........

    Quote Originally Posted by mdunn View Post
    I am coding for the hospital, so using modifier 54 does not really apply. I understand coding for the ER and then seperately coding for they physicians office, but what about when coding for the facility?

    In addition to what Tessa has stated, if the ORTHO doc is taking the pt to your OR you will code the procedure that is being performed. If it is the same procedure code look to see if there is an appropriate modifier you must apply.

    hope this helps.

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