ED Coding and Reimbursement Alert

Question: If the physician supervises the nurse as she applies a splint, can I charge a professional fee for the splinting? In this case, they used a "plaster" splint, and the doctor supervised the nurses by teaching them how to apply it and checking afterward.

California Subscriber Answer: For Medicare patients, the "incident-to" rules do not apply in the emergency department, and conservatively, the doctor should personally apply the splint. For other payers, carriers may have individual polices. At a minimum, the physician should demonstrate involvement in the process and assessment of the neurovascular status and alignment of the splint post-application. Because payer policies vary, it may be prudent to check with your carrier.