tci ED Coding & Reimbursement Alert - 2004 Issue 10

Reader Questions: Don't Wait for X-Ray Results to Report Fractures

Question: When a patient with a fracture presents in the ED, our practice's current pattern is to wait for x-ray confirmation to report the fracture. If the x-ray comes back negative for a fracture, our coder asks the treating physician to amend his documentation, and claims she does this because she wants to code to the highest degree of certainty. Do we need to keep this up, or can we make a final code decision about the fracture without test confirmation?       Arizona Subscriber Answer: Some fractures the physician can diagnose clinically, such...

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