Wiki Fracture Care

[LLRodgers]

Hello,

In general can anyone advise when you should use fracture care?

Does the physician have to do a manipulation on the fracture to use fracture care or can you use it on any fracture? I know there has to be restorative treatment - does restorative treatment include just putting them in a boot or cast with no manipulation.

Having issues where office staff is telling patients that it is Fracture Care and then when I get it to be coded I us a straight E/M code.

Thank you,
LLR

 

[Orthocoderpgu]

Your physician does not have to perform manipulation in order to bill fracture care.

Usually the site of the fracture is either casted or splinted, but now always.

During fracture care your doc will have the patient return several times to make sure that the fracture is healing and has not become displaced since the last visit. You can charge for X-rays during this period.

Yes, you may also bill an E/M on the same day that fracture care is started because the fracture needs to be evaluated first. Not all clinics do this, but you can.

Most important, make sure the physician specifically states that they are "initiating fracture care". You don't want this to be "Implied". Insurance companies know that many physicians don't like to specifically state that they are initiating fracture care, so they take their money back.