Wiki CRPP pulling pins and fracture care no cast

[smros]

HI everyone: Two questions

#1 -- Dr. does a closed reduction percutaneous pinning in the OR, we see the patient in follow up, they are casted, seen again and pins pulled. Dr. thinks that we should be billing for the pin removal, (it is being done in the office). Is this billable? What code?

#2 -- For fracture care when we are not casting, nor putting on a splint here in the office, should I use the fracture care code with modifer 52?

Thanks!

 

[MMadrigal]

I would like to know the answer to your question #1 as well,

for #2, If the patient is in a Global for the Closed Reduction, then there would be no charges generated for that 90 day period, with the exception of new cast applications and cast supplies, with mod-58. We code a 99024 when a patient is in a Global, and there is no charge generated for the visit. Mary

 

[Laxwido]

My 2 cents....

#1 We do NOT bill for pulled pins in the clinic, in the global peroid. In MCR patients there needs to be a return to OR for billing these, so we extended taht logic to other payors. Plus, I am pretty sure I attended a conference with Margie Vaught, who shared that same opinion.

#2 Not sure MM got the question, but i think I do.
We rarely see a fracture that requires us to treat without a cast, brace, or splint.
Clavicle fx's often do not get a casting/brace, but the Coders Desk Reference explanation of closed
clavicle fx treatment says "the physician MAY apply....", whaereas other closed fx treatement code
explanations indicate a cast or brace IS applied to immoblize until stable.

So, I guess the question becomes-- if you are not applying a cast or brace, what fracture treatment are you providing?

 

[smros]

Hi, the office said that they are doing CPT 28470 -- Closed treatment of metatarsal fracture; without manipulation

Thanks!