Wiki Fractures

[sacrane]

Need some billing advice on fractures. One of my doctors saw a patient and dx a fracture and decided to do surgery a few days later. But he wants to code the fracture care during the first visit. Is that o.k.? We told him that we can't but I'm not finding much to support our decision.

Thanks!
Sarah Frick, CPC
Greater Hartford Orthopedics

 

[mitchellde]

what was performed on the first encounter? If no fx care was performed you cannopt bill for it. If it was performed then yes bill for it, the surgery then will be in the global and will need a modifier.

 

[sacrane]

I believe he came from the ER as follow-up.

 

[mitchellde]

so the first visit you provider looked at the xrays and evaluated the patient and decided to set up surgery? If so then he bill an E&M and then surgery. It all depends on what the ER did and what your provider documented.