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Thread: Need Verification on Guidelines

  1. #1

    Default Need Verification on Guidelines

    AAPC: Back to School
    I need some updated opinions on acute vs. aftercare.
    Pt was seen in ER aftering falling and after xray he had non-displaced fracture of the elbow. ER doc placed splint and referred him to ortho. Ortho rev'd xrays and removed splint and placed a different splint on pt. At his point does it become a/c for the ortho or would it still be acute and can the ortho code fx treatment w/o manipulation or just the application?
    Any help would be greatly appreciated.
    Stephanie, CPC, HCS-D

  2. #2

    Default Need verification on guidelines

    If the othopedic only looked at the x-rays received from the initial doctor and did not perform any fracture treatment, I would code V53.7 (Fitting and adjustment of Orthopedic devices) which includes removal of device and replacement of device.

    Hope this helps.

  3. #3


    Ok, that does help on DX. Now what about procedure code? Would you do regular OV E/M or can you use the application code?
    Stephanie, CPC, HCS-D

  4. #4

    Default Need verification of guideline

    I would use 29105 because under "Application of Cast and Strapping" the guideline states that this code would apply when the cast or strapping application is a replacement procedure used during or after the period of follow up care. I would not use a regular OV E/M because the orthopedic did not do the history and exam, he just studied the x-ray that was sent to him/her and decided to only replace the splint without any restorative treatment. This code also includes removal of the splint.

    Hope this was helpful.

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