Results 1 to 7 of 7

Fracture Care Coding-Could someone help me

  1. Default Fracture Care Coding-Could someone help me
    Medical Coding Books
    Could someone help me (I'm new at coding orthopedics)? If a physician sees the patient in the office for a fracture, orders x-rays which confirm the fracture, but does nothing and does not plan to do anything but limit the patient's activity, pain meds, etc; can fracture care be billed in addition to the office E/M code?.

    Thanks.

    Sorry, I posted this in the wrong forum.

  2. #2
    Location
    will join Pasadena,Ca
    Posts
    19
    Smile Xrays
    Yes. Put whatever level e/m code and add mod 25..if billing medicare put the physican as the refering physican in bx 17 on the hicfa

  3. #3
    Default
    I believe that if it's the providers intent to manage the patient's fracture, whether a cast is applied or not, fracture care is appropriate. Also, Medicare requires a 57 modifier because the fracture care carries a 90 global, I am not sure about other payers, but I think 57 is more appropriate is you are billing fracture care in addition to an E/M. If the provider doesn't indicate that the patient needs to follow-up, or to just call if the patient has any problems, or just to follow-up prn, then I am not sure that fracture care is appropriate. It all depends on the intent to manage the fracture.



    Stefanie Cramer, CPC
    Independent Contractor
    Medical Coding and Consulting
    Cramer Consulting

  4. Default
    Fracture care : does it necessarily mean there should be a surgery?; I feel it can be any procedural care/service provided in relation to the frature by the physician, is enough to label it as 'Fracture Care'(Ofcourse with certain other criteria to be met). What I am trying to point is the modifier 57 is 'Decision for surgery '. Unless the care lands up for surgery how would we append this 57 modifier.
    This out of ignorance I am asking.

    Well, the 90days care plan is one of the mandatory criteria but it can mean that follow up upto 90days of the fracture care as well, to be sure of the healing status, and not necessarily 90days following surgery; meaning 90days credit being given to the fractured Status than necessarily a 'post surgery status' alone in fracturecare category ,though we have the global rule for surgery sections.
    Just the modifier doubt!
    Thank you.

  5. Default
    How would we append 57 for this fracture care. Fracture care not necessarily to land up in surgery (57 is for Decision for Surgery).Would n't any procedural care/Service suffice ?(ofcourse have to meet the criteria mandated to label as Fracture Care)
    The 90 days follow up plan is a mandatory criteria to code/bill it for F care of course. The 90days credit here in Fcare, I feel, is for the fracture healing follow up rather than exclusively for surgery that should have taken place.
    Could I have some enlighening please?
    Thank you

  6. #6
    Default
    This link might answer you questions:

    http://www.aaos.org/news/aaosnow/jul08/managing2.asp



    Stefanie Cramer, CPC
    Independent Contractor
    Medical Coding and Consulting
    Cramer Consulting

  7. Default
    Thank you very much. It is an amazing site. Yes, that is what I needed to know. Yes, the modifier 25 or 57 depending upon the service/procedure/surgery undertaken.
    Thank you once again

Similar Threads

  1. Replies: 5
    Last Post: 03-20-2017, 05:22 PM
  2. Fracture Care Coding-I have a patient
    By urbach34@yahoo.com in forum Orthopaedics
    Replies: 2
    Last Post: 11-12-2015, 03:00 PM
  3. Fracture Care Coding in Urgent Care
    By christi3_ in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 10-03-2014, 02:21 PM
  4. Closed Fracture Care and Open Fracture Care
    By kathy a in forum Orthopaedics
    Replies: 6
    Last Post: 07-09-2012, 11:07 AM
  5. Fracture care and E/M coding
    By dgerry in forum Orthopaedics
    Replies: 5
    Last Post: 05-22-2012, 08:33 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.