tci ED Coding & Reimbursement Alert - 2004 Issue 8

Reqder Question: Usually Report Closed Treatment in ED

Question: What does "closed treatment" mean in the case of a rib fracture? The standard care for rib fractures is generally rest and pain control. Should I report an orthopedic code with modifier -54 (Surgical care only)? Michigan SubscriberAnswer: CPT defines fracture care by the type of treatment the doctor provides, not by the type of fracture. "Closed treatment" specifically means that the physician does not surgically open the fracture site. An emergency department physician usually provides closed treatment only, even when caring for an open fracture. As with all of the CPT surgical codes, use of code 21800...

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