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Orthopedic Aftercare - When coding a follow-up

  1. Default Orthopedic Aftercare - When coding a follow-up
    Clearnace Sale
    When coding a follow-up visit for fracture repair in the orthopedic office, does anyone use the V codes, and if so, do insurance companies pay for them? For example, I use V58.43 for aftercare, I work at a large company, so have not been tracking the payment.

  2. #2
    Milwaukee WI
    Default Global period
    I'm not sure I understand your question. If it's in the global period (90 days) then there should be no charge and if there IS a charge, the insurance company will likely deny as "global."

    We DO use 99024 to track these visits, but that CPT carries a $0.00 fee and is not reported to the insurance company. And we use V codes as our Dx.

    F Tessa Bartels, CPC, CPC-E/M

  3. #3
    ditto to Ftessa's reply

  4. Default
    Sorry for the misunderstanding. This is after the global period, say follow-up 3 months and 2 weeks for a total knee arthroplasty and I would use a follow-up E/M code.

  5. #5
    Hartford, CT
    I have used the following codes with good results. For follow up of fractures, if they are still healing I use V54.1x (healing traumatic fractures) or V54.2x (healing pathological fractures). If the fractures are healed then I would use V67.4 (Follow-up of a healed fracture). For total joints I have used V67.09 (Follow-up after other surgery) along with V43.6x (joint replaced by other means). Hope this helps.


  6. Default
    Thank you Doreen. Do they pay for the V codes?

  7. #7
    How about V54.81 "Aftercare following joint replacement" along with V43.6x for totals?

  8. #8
    Smile All but BCBS of FL in my case
    I use the V-codes and am in FL.
    BC does not use the V-codes. I do not understand why, because that is correct coding if they are coming in with no complaints to check on a healing fracture and the 90 day global. But BC of FL does not take them.
    MCR definitely wants them. I use them for everyone else also.

  9. Default Help with Aftercare dx codes
    I could use some help with understanding the use of aftercare codes. I believe I understand the use of the codes during the global period. After the global period, what do I look for in the documentation to let me know that I should use an aftercare code? Does the note need to say that the pt. is there for followup of fracture or surgery? How long after fracture care or surgery would aftercare apply?

    I would also appreciate information regarding any references that would be helpful in ortho coding.

    Ruth Hood, CPC

  10. #10
    Default Use of Aftercare Codes for admits to Rehab facilities
    Hi Hope you can help clarify the correct use of aftercare codes!

    1.) Can they be used for admits to rehab facility by the primary care physician for the reason for admission. Or are these codes primarily for the Surgeon?

    2.) V66.4 Convalescence following treatment of fracture; can this be used for patients that are not recieving Palliative care?See Code corrects description.

    V66.2 Convalescence and palliative care following chemotherapy
    V66.3 Convalescence and palliative care following psychotherapy and other treatment for mental disorder
    V66.4 Convalescence and palliative care following treatment of fracture
    V66.5 Convalescence and palliative care following other treatment

    3.) I know for the facility side they do want the V code for the follow up aftercare etc... My questions all pertain to the Professional Component for the Initial visits 99304-99306. Any help would be appreciated.

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