Clip and Save This Related-Fracture Care Chart To Get 100 Percent of Your FPs Services
Published on Fri Aug 01, 2003
Don't lose out on entitled revenue when your family physician (FP) treats fractures or replaces a cast. This handy chart will eliminate confusion over choosing a fracture or a cast and strapping code, and a quick glance will tell you whether to bill for an E/M service, x-rays and/or supplies.
To determine the appropriate combination of codes, consider the FP's role in caring for the injury. "During any encounter, if the FP performs in-office x-rays, you should report the appropriate codes using the radiology code(s) for x-rays," says Beth Glenn, CPC, CMA, certified coder for Jefferson Family Physicians in Jefferson City, Tenn. In addition, report any supplies with a HCPCS level-two supply code. For payers that do not accept HCPCS codes, use 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]). For a significant, separately identifiable E/M service, append modifier -25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to the E/M code, such as 99201-99215 (Office or other outpatient visit for the evaluation and management of a new or established patient ). Also, you may use the global follow-up 99024 (Postoperative follow-up visit, included in global service) when the FP replaces a cast or provides follow-up care.
Both Glenn and Marie Felger, CPC, a family practice coding consultant and American Academy of Professional Coders-certified coding instructor with Joy Newby & Associates LLC in Indianapolis, suggest that FP coders adhere to the above guidelines: