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Need Verification on Guidelines

  1. Default Need Verification on Guidelines
    Medical Coding Books
    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. 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. Default
    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. 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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