# Office visit E/M with modifier and splint application



## JennyPie (Apr 9, 2013)

Scenario:
New patient, fell off a swing, our physician orders an x-ray, it was determined there was a buckling fracture of the distal radius. Our tech applies a long arm volar (plaster) splint. The visit meets a level 3. Since the physician performed a work up of this extent and it was decided to apply the splint as a result of the findings is this considered a separately identifiable procedure? Would we be able to bill the E/M w/modifier and splint application together? Our office doesn't currently bill for the supplies. 

I know we can bill the splint, just not sure if this warrants a modifier -25 to the E/M so we can capture both.


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## brendalewing (Apr 9, 2013)

Is your doctor Orthopedic? Why not bill for fracture code? 25600 Closed treatment of fx w/o manipulation... and not bill office visit.


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## nyyankees (Apr 10, 2013)

JennyPie said:


> Scenario:
> New patient, fell off a swing, our physician orders an x-ray, it was determined there was a buckling fracture of the distal radius. Our tech applies a long arm volar (plaster) splint. The visit meets a level 3. Since the physician performed a work up of this extent and it was decided to apply the splint as a result of the findings is this considered a separately identifiable procedure? Would we be able to bill the E/M w/modifier and splint application together? Our office doesn't currently bill for the supplies.
> 
> I know we can bill the splint, just not sure if this warrants a modifier -25 to the E/M so we can capture both.



Yes on 25 modifier. If you report Global fracture code I would still use the level 3 E/M and append 57 modifier. It' a new patient and the doc should report the E/M.


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## jcbritton (Apr 10, 2013)

http://www.aaos.org/news/aaosnow/jul08/managing2.asp

This may be helpful, it's a great article.


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