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Is this fracture care?

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    Would it still be possible to get this article? We are acquiring ortho practice which is new to our multi-specialty group and no orth coders.

  2. #12
    Kansas City, MO
    Quote Originally Posted by jdibble View Post
    Any help I could get with this would be apprecaited!

    I have been coding an ortho's surgical charts, but now they are missing charges for their office visits and hospital visits and have asked me to do an audit. I have found that the office has somehow missed billing a slew of charges for fracture care and initial E/M and has just been posting the follow up visits as post op, no charge. I am going through these accounts to see what charges are missing and have a few questions since I usually don't do the office charges.

    1. If the patient was seen as an inpatient for say a pelvic fracture and no surgery is done or manipulations or casting (or any other fracture that nothing physically was performed), but the doctor follows the patient in the hospital and then as OP, would this still be considered fracture care or would I bill each indiviual E/M?

    2. From the patient history in billing, the doctor saw the patient for the initial care, but I do not show any other visits posted - would I still bill for fracture care if the patient never returned for follow up visits (assuming it was the patient's decision not to return)?

    3. Fracture care includes the first cast, however if the cast needs to be replaced during the global period, how would this be billed? Which codes would be used and/or casting supplies billed?

    Thanks for any help with this - I have to meet with the Ortho office tomorrow and I would like to go in there with some knowledge of what to tell them.

    1) I would disagree with others on this one. We bill fracture care for closed treatment w/o manipulation (27193) if the doctor is following the patient in the hospital and will follow after discharge. If no follow up then we would bill the E&M instead.
    2) We bill this as fracture care if the patient is expected to follow up with our office.
    3) We bill using the appropriate casting application code and Q-code for supplies.

    Ortho Surgeons, Inc.

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