# Splints - If the Dr orders a splint but a nurse



## alices (Dec 30, 2009)

Hello all

If the Dr orders a splint but a nurse applies it can you code it for the Dr. since he ordered the splint? we are having a controversy here and I was told we couldn't that the Dr. had to place the splint in order to bill. Can you please tell me where I can find it in writing either way..I appreciate any and all help.

Thank You
Alice


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## JulesofColorado (Jan 5, 2010)

I don't know where to find it in writing, but I was trained to code the application of the splint even if applied by the nurse. Sorry I can't be of any more help.


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## ahinman (Jan 8, 2010)

I wish I had a black and white answer also...usually what happens in our ED is the physician orders, nurse applies but the physician does all of the neurochecks and examination following splint application.


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## cathyflower (Jan 9, 2010)

I was taught that in order for an ER physician to bill for service, He/SHe must perform the service.  Nursing Services are not billable by an ER physician because they are covered by the facility side. This would be considered double billing/unbundling.


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## ptrautner (Jan 10, 2010)

*Re splints*

The doc would have to state that he/she applied the splint to bill it out the the professional side. If he/she did not state that they did it or state the nurse/tech did it, nursing(facility)would get billed and not the doc for the application.  hope that clears up some confusion.


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## Lisa Bledsoe (Jan 11, 2010)

I did ER coding many years ago and we were told we could code the splint application if the ED doc checked the application and noted correct placement, etc.  Not much help.


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## vdelucci (Jan 12, 2010)

For sprains I code splints if applied in the ED. For fractures I code the treatment code
which includes splints.


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## ptrautner (Jan 12, 2010)

Lisa Curtis said:


> I did ER coding many years ago and we were told we could code the splint application if the ED doc checked the application and noted correct placement, etc.  Not much help.



i think the doc always does the check, which is only required for medicare i have been told.  However, he/she would actually have to do the procedure to get credit.


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## LTibbetts (Jan 13, 2010)

Lisa Curtis said:


> I did ER coding many years ago and we were told we could code the splint application if the ED doc checked the application and noted correct placement, etc.  Not much help.



I agree. I do both the facility and the pro fees and we always count the splint on the physicians side. If it is written somewhere that this is incorrect, can someone please let me know where to find it so I can advise the coders?


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## alices (Jan 14, 2010)

*splints*

Thank You very much for everyone's input, we are having an audit today about the splints, so If they give me any hard facts about coding it or not I will let I will post it. Thanks again for all the help..alice


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## MedcodingSpecialist (Jan 15, 2010)

*Re:Splints*

If the physician has ordered splint and the nursing staff or technician has applied it, then in order to code for the splint, the physician has to check the neuro vascular status for self pay/commercial insurance. If the insurance is federal, the the physician himself has to place the splint or mentioned as applied by me.


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