Wiki Fracture Care Coding-I have a patient

[urbach34@yahoo.com]

I have a patient I am coding who has second, third, and fourth metatarsal fractures. Am I to code 28470 (closed treatment of metatarsal fracture; without manipulation, each) three times?

28470-Rt-x3

 

[dclark7]

It depends on the insurance company. Per the NCCI Policy Manual, chapter 4, Section F, Paragraphs 14; Medicare will only pay for one fracture code if the fractures are at the same anatomic site whether they are being treated with casting/splinting or not.

Your best bet is to contact the insurance companies you're dealing with and find out if they have a different policy of if they go by the NCCI manual

 

[urbach34@yahoo.com]

Thank you for your feedback. I greatly appreciate it