Forum - Questions & Answers
initial fracture care in ED
ED newbie here...
Have a couple of accounts with diagnosed fractures, want to confirm the phrase "initial fracture care" and how it s/b coded. Have gone over the notes and there are no restorative treatments/procedures documented - no mention of reduction anywhere. The only procedure noted is the splinting.
Believe the closed treatment of fx CPTs should NOT be coded here, just the splinting (and E&M etc).
Thanks for your help!
fracture
Only the physician who provides the “restorative” treatment and is responsible for the initial cast, follow-up evaluation(s) and the management of the fracture
until healed, should use the global fracture code. The proper coding is for the ED physician to code for the ED visit and application of a splint if appropriate.
If manipulative fracture care that meets the definition of “restorative treatment” is provided by an ED physician and the ED physician has provided a “significant portion of the global fracture care,” the ED physician may use the global code with modifier 54 (surgical care only). However, this treatment must meet the “restorative” care definition and should not be merely splinting a fracture after straightening the limb.
initial fracture care in ED
Great answer, clears up a lot. thanx again