smitchell200
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I have a question about billing for fracture care.
The patient fell a month before being seen and broke her toe. She was referred to an ortho specialist by her family physician. The doctor did an x-ray of the toes, showed the patient where the fracture was on the x-ray, advised her that she would need to wear a post-op shoe and watch for signs of skin breakdown, as the patient is a diabetic.
He advised that the nurse was going to put gauze in between the toes, and place the patient in a shoe. This was not done, because they did not have the right size shoe. The patient was given a bad of gauze pads to use in between the toes later.
The physician billed for a level 3 consult, fracture care of the toe, and for the x-ray.
I questioned the fracture care, and was told that because he was a specialist, and he looked at the foot, and since he advised the patient on what to do to treat the fracture, he was able to bill for that service.
I guess I am confused because I have been trained to not bill for this service unless the physician actually places the patient in a stabilizing device (I guess buddy-taping in this instance?), or does something more than looking at the toe and diagnosing the fracture (which he is reimbursed for by billing the consult code). Can you give me some input, because I am curious as to how specialty specific coders/billers are doing this, and why it is different because he's a specialist?
Thank you!
The patient fell a month before being seen and broke her toe. She was referred to an ortho specialist by her family physician. The doctor did an x-ray of the toes, showed the patient where the fracture was on the x-ray, advised her that she would need to wear a post-op shoe and watch for signs of skin breakdown, as the patient is a diabetic.
He advised that the nurse was going to put gauze in between the toes, and place the patient in a shoe. This was not done, because they did not have the right size shoe. The patient was given a bad of gauze pads to use in between the toes later.
The physician billed for a level 3 consult, fracture care of the toe, and for the x-ray.
I questioned the fracture care, and was told that because he was a specialist, and he looked at the foot, and since he advised the patient on what to do to treat the fracture, he was able to bill for that service.
I guess I am confused because I have been trained to not bill for this service unless the physician actually places the patient in a stabilizing device (I guess buddy-taping in this instance?), or does something more than looking at the toe and diagnosing the fracture (which he is reimbursed for by billing the consult code). Can you give me some input, because I am curious as to how specialty specific coders/billers are doing this, and why it is different because he's a specialist?
Thank you!