Reader Question: Fracture

Question: A Medicare patient seen in the ED is diagnosed with a humerus fracture, and the injured arm is placed in a sling. Subsequently, the patient is admitted to an observation bed because of a hypotensive episode that occurred in the ED. Can we bill the ED E/M code and the application of the sling in addition to the observation service by using revenue code 762 (observation) and number of hours (for which there is no reimbursement)?

California Subscriber

Answer: In this case, code both the E/M level and the application of the splint. Medicare does not reimburse observation under APCs for hospitals, therefore you should identify the E/M level. Also code the observation level (revenue code 762) because HCFA has asked providers to record the observation code for tracking purposes to establish data for possible creation of an observation APC.


- Published on 2001-06-01