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Fracture Care vs E/M

  1. #1
    Default Fracture Care vs E/M
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    Patient presents to office with hand injury of which the patient fell on 3 days prior. X-ray confirms triquetral fracture. Physician performs no manipulation but does splint. Would the appropriate CPT be 25630 or E/M. This patient we do plan to follow for ongoing treatment and will not be referred out to Ortho.

  2. #2
    It can go either way--up to the MD
    See attached site from the AAOS
    Tina Wosmek CPC, COSC

  3. Default
    We code both. The E&M will have a mod -57 on it.

  4. Default
    You would code both and the E/M has a mod 57.

  5. Default
    We only charge a separate E&M if there's manipulation involved. Since the non-operative fx care codes have an E&M component, we don't feel a separate E&M is warranted (unless, of course, there's a separate problem). If there's manipulation of the fracture involved, we do charge an E&M with modifier 57. Manipulation is "technically" a surgical procedure.


  6. #6
    Thanks this helped me out a lot!

  7. #7
    I would bill E/M-57 + Q code for splint + 25630 + x-Ray.

  8. #8
    Long Island/New York
    Quote Originally Posted by arme2783 View Post
    I would bill E/M-57 + Q code for splint + 25630 + x-Ray.
    yes you could...

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