# fracture reduction in ER



## sam_son  (Mar 12, 2009)

*hai*

If the ER dr reduces the fracture then how come the ortho DR again reduce the fracture in OR , if the document  is like that means , may be the ER Dr places the splint or he may try to reduce the # , however the ortho Dr states he reduce the # means we have to code # care for ortho only. for ER we have to code splint , this is my veiw.


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## FTessaBartels (Mar 13, 2009)

*Fracture care*

Fracture care carries a 90-day global period.

Since your ER physician is NOT going to be doing any follow-up on this case, I would recommend that you code the ER visit and the splinting. 

If the documentation is *very clear *about reduction/*manipulation*, then you could code the fracture care with a -54 modifier since you won't be providing any follow-up. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## dmaec (Mar 13, 2009)

very nicely stated Tessa!  great clarification of services AND reminder of the necessary use of modifier 54 !


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## ptrautner (Mar 19, 2009)

our policy is if patient is immediately going to ortho we would never charge fracture managment in the ed. now, if they are going in a few days to follow up esp if our doc did reduce the fracture, we would then charge fracture care. in this case you are always safe to charge a splinting.


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## 808coder (Jun 18, 2009)

*Fracture question........*



mdunn said:


> I am coding for the hospital, so using modifier 54 does not really apply. I understand coding for the ER and then seperately coding for they physicians office, but what about when coding for the facility?




*In addition to what Tessa has stated*, if the ORTHO doc is taking the pt to your OR you will code the procedure that is being performed.  If it is the same procedure code look to see if there is an appropriate modifier you must apply.

hope this helps.


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