tci ED Coding & Reimbursement Alert - 2008 Issue 5

Reader Questions: Use Notes to ID Fracture Treatment Type

Question: The ED physician performs closed treatment on a patient's ulnar shaft fracture. There are two codes for this procedure: 25530 and 25535. How do I choose between the two codes? Nebraska SubscriberAnswer: You-ll have to check the physician's notes for evidence of manipulation. If the physician performed the definitive treatment without manipulation, you-d report 25530 (Closed treatment of ulnar shaft fracture; without manipulation). But if the physician used manipulation, report 25535 (- with manipulation) instead.How to tell: You can always ask the physician whether he performed manipulation before choosing a code, but there are often clues within...

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