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Thread: Fracture care

  1. #1
    Join Date
    Apr 2007

    Default Fracture care

    AAPC: Back to School
    I'm new to coding and confused and I work for a Peds Doctor. How do you decide to bill only for the fracture code and not the E/M? how much of an examine does the Doctor have to do to bill for both e/m and fracture? According to the 1995 guideliness.

    Help is most appreciated

    Confused Coder

  2. #2
    Join Date
    Apr 2007
    Greeley, Colorado


    The doctor can choose to charge either the fracture care OR the E/M - not both. I would base it on the fracture and if the patient will be returning for follow up since these codes have 90 day global periods. Personally, I would code an E/M for something like a simple finger, but fracture care for a wrist...
    Lisa Bledsoe, CPC, CPMA

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