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time frame for fracture codes

  1. #1
    Default time frame for fracture codes
    Medical Coding Books
    Good afternoon everyone,

    Is there any coding guidelines (time frame) for fracture codes? Patient comes to clinic after 2 or 3 months. Still physcicians are using 8XX codes . My manager showed me some state audit report saying that all 8XX codes required E codes. As for as I know you can use the E code only the day of accident/ first visit to ER or physician's office .

    Should I use E codes for follow up visits along with fracture codes.

    I would like to get your opinions.

    Thank you

  2. #2
    Location
    Marquette Michigan
    Posts
    5
    Default
    You may only use the 8XX codes during the acute phase of the fracture (the first encounter).
    Every encounter thereafter shoud use a V54.XX to show the healing phase of the fracture.
    No E codes are required with the V codes.

  3. Default
    I agree with Centko. We bill them for the inital encounter then use the aftercare V54.XX codes for visits after that. I would not bill the E code for follow up visits.

    Kelsey, CPC

  4. #4
    Default
    Quote Originally Posted by kumeena View Post
    Good afternoon everyone,

    Is there any coding guidelines (time frame) for fracture codes? Patient comes to clinic after 2 or 3 months. Still physcicians are using 8XX codes . My manager showed me some state audit report saying that all 8XX codes required E codes. As for as I know you can use the E code only the day of accident/ first visit to ER or physician's office .

    Should I use E codes for follow up visits along with fracture codes.

    I would like to get your opinions.

    Thank you
    E codes are not required, you do not need to use it unless payor requires you to use it. However if you want to use E codes, then you need to use them only on first encounter with injury code. Follow-up fisits would be coded from V54.xx category. Our office does not use E codes at all and we are orthopaedic office.

  5. #5
    Default
    Thank you everyone. I appreciate your help

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