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Fracture Care vs No Fracture Care

  1. #1
    Location
    Swainsboro/Statesboro
    Posts
    673
    Default Fracture Care vs No Fracture Care
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    There is a debate going between coders here at my facility. Maybe I can get some other opinions out there:

    The patient presents to the ER with injuries. The physician diagnosis the patient with a zygote and orbital wall fracture and transfers the patient by ambulance to a bigger facility in a separate town.

    The ER doctor did use ice; x-rays; and pain management.

    Would you code this fracture care or just the E/M level?

    Thanks, Susan
    Susan Edwards, CPC, CEDC, AAPC Fellow
    Swainsboro/Statesboro Georgia President

    smecoder@gmail.com

  2. #2
    Location
    Columbia, MO
    Posts
    12,570
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    This is not fracture care it is comfort care and patient management, therefore E&M only.

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Location
    Swainsboro/Statesboro
    Posts
    673
    Default
    Thank you Debra, that was my opinion that I was debating. I am going to print and show your answer.
    Susan Edwards, CPC, CEDC, AAPC Fellow
    Swainsboro/Statesboro Georgia President

    smecoder@gmail.com

  4. #4
    Location
    Swainsboro/Statesboro
    Posts
    673
    Default
    Not sure on that one, because I was told that the Physician has to be the one to actually put the splint on....
    Susan Edwards, CPC, CEDC, AAPC Fellow
    Swainsboro/Statesboro Georgia President

    smecoder@gmail.com

  5. #5
    Location
    Columbia, MO
    Posts
    12,570
    Default
    I would not unless the Er is going to assume all fracture care which includes the followup. I would bill only the ER level for the Physician, the facility will bill the splint code since it was applied by nursing staff.

    Debra A. Mitchell, MSPH, CPC-H

  6. Default
    Thank you to both of you for settling the debate.

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