Solve this common fracture scenario: Patient presents to the ED with wrist pain

by Laura Evans, CPC on Sep 5, 2019
A patient presents to the emergency department after falling off a ladder. The ED physician examines him and determines that the patient has fractured his distal radius and ulna. The physician then applies a short arm splint to stabilize the fractures and instructs him to follow up with an orthopedic surgeon. 
 
Question: How should the physician's service be coded?
 
Answer: To correctly answer this question, first you must answer two other questions, the AMA says:
 
1. Has the ED doctor done any restorative treatment?
 
2. Will the ED doctor assume all subsequent fracture care of the patient during the global period?
 
The answer to the above questions would appear to be "no," so the ED physician should report code 29125 for application of a short arm splint, and -- if the documentation meets the key components -- an E/M code may be reported with modifier 25.
 
This is just one of many fracture coding situations that will be addressed during the webinar, Reduce Fracture Coding Headaches and Ensure Proper Reimbursement, Tuesday, Sept. 10 at 1 PM ET. Attendees will receive free, unlimited access to the on-demand version of the webinar. AAPC and AHIMA CEUs available.
 
 
 
 
 
 
 
Blog Tags: AMA
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