# Fracture Care vs E/M



## MWOOD (Aug 19, 2011)

Patient presents to office with hand injury of which the patient fell on 3 days prior.  X-ray confirms triquetral fracture.  Physician performs no manipulation but does splint.  Would the appropriate CPT be 25630 or E/M.  This patient we do plan to follow for ongoing treatment and will not be referred out to Ortho.


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## twosmek (Aug 19, 2011)

It can go either way--up to the MD
See attached site from the AAOS

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


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## alb7585 (Aug 19, 2011)

We code both. The E&M will have a mod -57 on it.


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## campy1961 (Aug 19, 2011)

You would code both and the E/M has a mod 57.


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## Treetoad (Aug 20, 2011)

We only charge a separate E&M if there's manipulation involved.  Since the non-operative fx care codes have an E&M component, we don't feel a separate E&M is warranted (unless, of course, there's a separate problem).  If there's manipulation of the fracture involved, we do charge an E&M with modifier 57.  Manipulation is "technically" a surgical procedure.


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## MWOOD (Aug 22, 2011)

Thanks this helped me out a lot!


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## armen (Aug 22, 2011)

I would bill E/M-57 + Q code for splint + 25630 + x-Ray.


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## nyyankees (Aug 22, 2011)

arme2783 said:


> I would bill E/M-57 + Q code for splint + 25630 + x-Ray.



yes you could...


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