tci ED Coding & Reimbursement Alert - 2004 Issue 11

You Be the Coder: Should You Report Fracture Care and E/M Services Together?

Question: If I report a code for definitive care of a fracture, does it include evaluation and management services? Should I just report the CPT code for the fracture and no E/M code?              Alabama SubscriberAnswer: Rarely is it appropriate to report only a fracture care code without an accompanying E/M code in the emergency department (ED). For starters, most fracture treatment requires a history regarding the mechanism of injury, a thorough physical exam, and a thorough assessment of the patient. And the physician must perform...

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