Podiatry Coding & Billing Alert

Question: We had a patient come presenting a fractured left great toe. We billed for the x-ray and fracture care. He came in later that week with severe pain after dropping something on the fractured toe. He now has two fractures on the same toe. Comparing the two x-rays, you can see the fracture occurred after the first visit. Will adding an “A” to the fracture diagnosis codes make it look like we’re billing for the same incident twice? How can we bill for the x-ray and fracture without it looking like a duplicate claim?

Virginia Reader

Answer: You shouldn’t bill for fracture care again unless the actual treatment changes (i.e., open reduction, fixation, etc.). If the treatment continues to be closed treatment with immobilization, I would not consider billing fracture care again.

As for the x-ray, make sure your records document the two separate injuries at different times and indicate that a second fracture of the same toe occurred. There shouldn’t be an issue billing for the second x-ray, as it’s appropriate and reasonable to check for a new injury.