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Thread: Does Splinting fall under fracture care?

  1. #1
    Join Date
    Apr 2007
    SE Minnesota

    Default Does Splinting fall under fracture care?

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    I am wondering if you can bill for fracture care if you applied a splint or if it only applies to casting.

    From the other postings regarding fracture care in the forum, it appears you can, but I would appreciate a definitive answer and some supporting documentation if possible.

    We have a patient who has a distal tibial fracture and was put in a walking boot/splint and the doctor is wondering if he can bill fracture care for this. There was no manipulation.

    Thanks for your help in advance.
    Cory Bauer
    Rochester, MN

  2. #2
    Join Date
    Apr 2007


    (1) You are seeing the pt for the initial visit for injury.
    (2) The injury is acute occurring within the last 2 weeks. One exception to this could be undiagnosed scaphoid fracture which often take longer to show up on a-rays.
    (3) Patient has not had surgery for this injury by another physician in a different practice
    (4) You plan to care for this fracture for the next 90 days
    * If the patient was seen in the ED or by another physicians office and later sent to an ortho for fx care confer w/your physician regarding billing fracture care.Generally with orthos the pt is seen initially in the ED then they are sent to an ortho-these can still be billed out as fracture care codes.
    (1) If the fracture is old.
    (2) If there is a non-union of the fracture
    (3) The fracture is healed or mostly healed
    (4) Your doc isn't going to care for this fracture for next 90 days
    (5) No followup appt. are recommended
    (6) Patient is scheduled for pinning or open treatment.

    I found this on this website under a similar question as yours-when you have the time check out questions/answers thru out this Orthopedic subsection for great tips. The above I cut out & taped to my computer terminal.Hope this helps.


  3. #3
    Join Date
    Apr 2007
    Columbus, OH


    If this is the initial treatment of the fracture you can bill the fracture care code even if a splint was given instead of a cast. You can not bill for the splinting though, it is included in the fracutre care. You can bill for the materials though.
    Kathy Daniel, CPC, COSC

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