Primary Care Coding Alert

Reader Question:

Fracture Care Can Apply, Even Without Manipulation or Follow-Up

Question: Our physician saw a patient for a non-displaced tarsal bone fracture, which did not require manipulation. He placed a prefabricated short leg, removable cast instead of applying a full cast. Documentation states that the patient shouldn't need additional treatment, but our physician recommended that she see an orthopedist in 2 weeks. Should we consider this encounter a type of fracture care?

Nebraska Subscriber

Answer: Your physician determined that there is a fracture and decided on the appropriate course of treatment, so he met the requirements for reporting the fracture care code. Submit  28450 (Treatment of tarsal bone fracture [except talus and calcaneus]; without manipulation, each). 

Note: Because your physician won't be providing the associated follow-up fracture care included in the global surgical package, append modifier 54 (Surgical care only) to indicate you are reporting only the procedure.

Other Articles in this issue of

Primary Care Coding Alert

View All