tci ED Coding & Reimbursement Alert - 1998 Issue 1

Use Orthodpedic Codes Plus Modifier -54 to Get Paid for ED Fracture Care

Many EDs have trouble getting paid for treating fractures, sprains, and other orthopedic injuries. In fact, some departments have stopped submitting orthopedic codes altogether.But, with a basic knowledge of coding requirements and good communication between ED coders, physicians, and the orthopedic specialists, EDs can get their deserved reimbursement for these services, say experts. For starters, ED coders must understand that orthopedic codes may be used only when the definitive or restorative care is delivered in the department. And, when orthopedic codes are used, the ED coder must append the -54 modifier. (See sections on restorative care and modifier -54...

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