ED Coding and Reimbursement Alert
How Solid is the 72 Hour Rule for Fracture Care Reporting? Find Out
Question: I was wondering if I could have your feedback regarding a topic of conversation that many of my groups are experiencing. We are seeing a large increase in the number of fracture care. Below is the coding policy they follow. Can you enlighten me about the 72-hour rule? I have found a few articles but none of them talk about this 72 hour window. How do other groups handle fracture care in this manner? Any information you can provide will definitely assist me.
Illinois Subscriber
Answer: The time frame is a proxy for definitive care so another option is to have the ED docs write a fracture care note when they feel they have provided definitive care. The 72 hours is set by internal policy discussion for most groups. I’ve seen them as short as 24 hours while others go as long as 96 hours. Most of groups usea standard of 48 hours but a few do 72 to allow for the weekends.This is simply a proxy for definitive/restorative care.
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