I am NOT an Ortho specialist, BUT ...
It seems to me that you will never have just one answer to this. The key question is WHEN are you treating the fracture?
As you've no doubt noted, there are fractures that require only splinting (or even just buddy-taping - e.g. a broken toe). If the splint is the definitive fracture treatment, then code the fracture care and begin your global period. On the other hand, if you are just providing a temporary stablization and comfort before you can adequately evaluate and treat the fracture, code just the E/M & splint application for this first visit.
It is never appropriate to unbundle the service provided into E/Ms and splinting just because you may get paid more that way. (Although I agree that it doesn't make much sense sometimes how little we are paid for a global package on some procedures.)
Hope that helps.
F Tessa Bartels, CPC, CEMC
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