Bernadette10
Guru
For ortho clinic visits, is splint placement considered straightforward or low MDM? Would this be 99212 or 99213? I'm thinking the splint is straightforward MDM, so would give this 99212, but would like to know others' opinions. I think ortho visits often don't fit very well into the 2021 guidelines. What if this had been a finger fracture with cast placement and one x-ray, 99213? I think a fracture with cast would raise the risk to low.
Diagnosis: Partial boutonniere injury
Orders: X-ray LT finger 3 views - No fractures or dislocations.
HPI: The patient jammed her LT ring finger while playing cards 2 months ago, and it has not gotten better.
Exam: LT hand: She has some tenderness over her PIP joint, which is the source of her chief complaint. She lacks about 10 degrees of full extension of the LT ring finger. She does not have an appreciable boutonniere-type deformity. Has 4.5/5 extension strength of the LT ring finger. Good flexion about the finger.
Plan: Splinting and PIP extension. She can move her DIP joint. I would like for her to wear this over the next 3-4 weeks, and we'll see how she does with it.
Diagnosis: Partial boutonniere injury
Orders: X-ray LT finger 3 views - No fractures or dislocations.
HPI: The patient jammed her LT ring finger while playing cards 2 months ago, and it has not gotten better.
Exam: LT hand: She has some tenderness over her PIP joint, which is the source of her chief complaint. She lacks about 10 degrees of full extension of the LT ring finger. She does not have an appreciable boutonniere-type deformity. Has 4.5/5 extension strength of the LT ring finger. Good flexion about the finger.
Plan: Splinting and PIP extension. She can move her DIP joint. I would like for her to wear this over the next 3-4 weeks, and we'll see how she does with it.