Upgrade your fracture care coding using 4 wise tips.
How can you tell if a claim merits a fracture care code or an E/M code? It's usually hard to tell right away as experts agree that code selection will likely depend on a case-to-case basis. But you wouldn't face a cul-de-sac if you could take the following 4 factors into account to find the best fit the fracture treatment.
1. Match Fracture Treatment with Criteria
You'd know you should report fracture care, if the scenario meets the following criteria:
The physician sees the patient for her initial visit for the injury (e.g., 826.x, Fracture of one or more phalanges of foot, and 838.xx, Dislocation of foot). The injury is recent enough that it has not already healed on its own.
The patient has not had surgery for this injury by another physician in a different practice. (For instance, if the patient was injured while [...]