I need some help with fracture care. I code for an Urgent Care and my doc says that he can bill for the fracture care. I have always thought that the Ortho billed for this once we refer over to them but he seems to think since we did not refer them for 3 days then he gets to bill the fracture care. Upon my research fracture care is following the patient through the 90 day global that goes along with the code. Here is the example: DX: Distal fibular fracture, no dislocation. Procedure Note: Appl. Splint - Short Leg: Appl. Orthoglass Posterior Splint to the right foot & Ankle . Good alignment, neurovascular intact. I coded out 29515 application of short leg splint and he thinks I should of coded the fracture care 27786. I explained to him that I did not see any documentation for that and anyway we referred him to an Ortho (Patient seen us Saturday referred to Ortho Tuesday) and that they would bill for the fracture care. Here is the response I got back from the doc: My understanding if you bill out next day or the same day then Ortho dont get paid, which is there problem, but when you treat them for 3 days you get paid and Ortho will bill for consult after the care. There was documentation of the fact that Orthoglass posterior splint was applied and the patient was examined post splint application, and it was good positioned neurovascularly intact, which is all the documentation required for the fracture care. This is not a prefabricated or velcro splint we slapped on his leg to go, and somebody else will bill them for the splint, we build the splint and apply it. Any assistance on this would be greatly appreciated or anything in black in white that I can get him or help me understand this better would be awesome. Maybe a link to some documentation. TIA
Posted on: Fri, 05 Sep 2014 17:22:31 +0000
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