tci ED Coding & Reimbursement Alert - 2001 Issue 5

Correct Ortho Codes for Fracture Care Depend On Extent of Treatment

"Coders may apply orthopedic codes for the treatment of fractures, sprains and other orthopedic injuries only when the ED delivers definitive care, sometimes also called restorative care. Definitive care aims to repair, rather than simply stabilize, the injury. An ED physician performs definitive care by applying the initial cast, handling the follow-up E/M and managing the fracture until it has healed. Along with casting, definitive care may also include splinting, strapping and/or pain management. Five Options for Fracture Care Coding Coders have five options when coding fractures in the ED, explains David McKenzie, director of reimbursement for the American...

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