tci ED Coding & Reimbursement Alert - 2005 Issue 6

READER QUESTIONS: Bill For Splint With Direct Application

Question: When can we code for splinting? Does the ED physician need to do a postapplication exam in order for us to code for splint application? Florida Subscriber Answer: Medicare does not recognize the "incident- to" provision in the emergency department, so in order to bill for splints for Medicare (and those payers following Medicare rules), the physician herself must directly apply the splint. The incident-to provision allows physicians who employ nonphysician practitioners, such as nurse practitioners and physician assistants, to bill for the NPP's services. However, this rule applies only to office settings, so ED physicians cannot use...

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