# Fracture and/or Dislocation



## Jackie1973 (May 25, 2010)

Can someone tell me exactly what this consists of?  I do billing for a large Family Practice Clinic and I'm the only CPC and I'm newly credentialed.  The child came into the office and had a fracture of the radius and the Dr. coded 24650 for closed treatment of radial head without manipulation and I can not find a good description of that procedure.  Can anyone help?  What kind of treatment is done?  It is a surgery code?  Thanks


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## RebeccaWoodward* (May 25, 2010)

24650-The physician treats a fracture of the end of the outer bone of the forearm on or near the point at which it connects to the elbow. The arm is immobilized. Code 24655 if the bone must be pushed back into place before it is immobilized.

Basically, for 24650 the fx has been determined to be stable and nondisplaced.  It can be splinted or braced without requiring manipulation.


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## Jackie1973 (May 26, 2010)

*Jackie1973*

So if a patient comes into the office and the provider determines there is a fracture and they cast the arm, they can use this code for visit?  I coded the proper E/M visit with cast application is this incorrect?


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## RebeccaWoodward* (May 26, 2010)

Jackie1973 said:


> So if a patient comes into the office and the provider determines there is a fracture and they cast the arm, they can use this code for visit?  I coded the proper E/M visit with cast application is this incorrect?



Fracture care codes include the application of the first cast. When the provider performs some type of restorative treatment to the fracture and applies a cast, you should report only the procedure code for the fracture care. *The application of the cast is included in the fracture procedure*. When (if) the physician replaces the cast in a subsequent visit, you can bill for the cast application with modifier 58.  

Typically, you can capture the E/M since there is a "decision for surgery".  You would apply modifier 57 to the E/M since fracture care has a 90 day global period.  So...you would bill for the E/M, fracture care code, and any cast *supplies*...

An example would look something like this...

99202-57 
25530 
Casting supplies


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## FTessaBartels (May 27, 2010)

*However*

However ... if all your physician is doing is stabilizing the fracture until the patient can be seen by an orthopaedic surgeon for definitive fracture care, then you would just code the E/M and splint application.

Only code the fracture care code if you will be providing the full "post-operative" 90-day care. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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