Results 1 to 9 of 9

billing fx care it the pt is only seen once?

  1. #1
    Default billing fx care it the pt is only seen once?
    Medical Coding Books
    My Dr. saw a pt that we got through the emergancy room. The patient had a pelvic ring fx. Dr did reviewed the x-rays taken from the hospital and his having the patient follow up as needed. Can we bill fx care for this pt, since he is not scheduled to follow up?

  2. Default
    Our group has an oral/maxillofacial surgeon who wants to do this. He sees the patient once and tells the patient to contact the office if there's a problem. Consider this.....most fracture care has a 90 day global period. The charge for fracture care is usually quite substantial (equal to a lot of surgical procedures). Is the work your surgeon providing equivilent to a surgical procedure? What are the chances the patient will have any follow up care at all? Your provider is pretty much taking the "wait and watch" approach. I suppose you could qualify this as non-operative fracture care. Personally, I feel a little funny charging fracture care when there's really not going to be a lot of follow up. If the provider reduced a fracture and planned routine follow up, I would have a different opinion. I guess if it were me, I'd charge the appropriate E&M service. If the patient did come back, the visit wouldn't be global so you could charge another E&M. I expect there are probably a lot of opinions out there in regards to this situation. Maybe someone will give me a reason to sway my opinion in the other direction?


  3. #3
    I agree with Treetoad to some degree--however technically speaking, YES, they are entitled to the fracture care. Its really no different than closed treatment of a fractured finger or something simple. They have rendered the treatment, they have given the patient the necessary instruction on care of the fracture and the do's and donts. They have "treated" the fracture. Generally the docs will tell the patient to follow up in a couple of weeks for a repeat x-ray. If the patient decides not to do that, then that was the patients decision.

    We charge the closed treatment of the fracture.

    Hope this helps

  4. #4
    I work for ortho surgeons and in our office if will only charge the fx codes if we know that they will be in for at least one or more visits containing new xrays or reapplications of casts. If he is PRN or discharged I would not reccommend charging out a fx.

  5. Default
    If the physician is not following the pt for the next 90 days, I would not suggest billing fx care.

  6. Default
    Thanks, pdelorenzo. You perfectly summed up the point I was trying to make.


  7. Default

  8. Default intent
    I believe fracture care is about intent. If the doctor intends to follow up with the patient, then it is perfectly ok to charge a closed fracture.

  9. Default
    Right, the physician intends on treating the pt for the global period! Mary is absolutely correct as well. Sometimes the pt does not follow against our physicians plans (or intent) however, as long as our dictations / medical records indicate accordingly - we're good to bill the non-manipulative fx fees!!!

Similar Threads

  1. Billing Urgent Care for Total Health Care Insurance
    By ccarte10 in forum Billing/Reimbursement
    Replies: 1
    Last Post: 12-29-2014, 09:03 AM
  2. Hospice Care Billing
    By sweetpe58 in forum Employment General Discussion
    Replies: 1
    Last Post: 06-05-2014, 01:58 PM
  3. URGENT CARE BILLING Fx CARE GLOBAL & "possible" interpretation
    By coding303 in forum Outpatient Facilities
    Replies: 5
    Last Post: 05-02-2014, 07:22 AM
  4. Billing OB Care
    By em2177 in forum OB/GYN
    Replies: 1
    Last Post: 05-15-2009, 08:00 PM
  5. Billing as Urgent Care
    By tkd in forum Medical Coding General Discussion
    Replies: 1
    Last Post: 01-27-2008, 08:20 PM

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?


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.