Health Information Management

Fracture care without follow-up

APCs Insider, October 28, 2003

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October 31, 2003
Vol. 4, No. 43



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Trick-or-Trivia

In Medieval times, a spider was rolled in butter and swallowed as a cure for what disease?

The answer will appear in next week's APC Weekly Monitor, or be one of the first five to e-mail the correct answer and win a 3-month free trial to one of our HCPro newsletters!

LAST WEEK'S ANSWER:
What recent celebrity gubernatorial candidate was affected by kidney disease that decreased his growth potential? Name the code.
GARY COLEMAN
KIDNEY DISEASE 585



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THE MONITOR'S ADVISORY BOARD

Keith Siddel
MBA, PhD (c),
president, CEO
HRM, Hospital Resource Management

Andrea Clark
RHIA, CCS, CPCH
president
Health Revenue Assurance Associates

Cheryl D'Amato
RHIT, CCS,
director, health information management
HSS, Inc.

Julie Downey
CPC, CPC-H,
ambulatory coding coordinator, HIM
University Colorado Hospital

Carole Gammarino
RHIT, CPUR,
Independent
Consultant

Jeannie Gourgeot
RT, RHIT,
Director of HIMS
St. Joseph's Medical Center

Julia R. Palmer
MBA, RHIA, CCS,
president, Health Information Management Division
HRM

Valerie Rinkle
MPA
revenue cycle director
Asante Health System


On Himinfo.com

TIP OF THE WEEK

ASK THE EXPERT


Happy Halloween!

This week's question asks how to code fracture care provided in the ED. Read on for our experts' no-bones-about-it answer.



Your APCs Weekly Monitor is a free weekly e-zine from HCPro, publisher of Briefings on APCs, the monthly newsletter devoted entirely to managing under APCs, and the newsletter, APC Answer Letter, with answers to readers' questions about coding for APCs.

The Monitor is a complimentary companion publication with a specific mission: to provide answers to your tough questions about the APC regulations.

If you have a question about APC coding that you would like addressed in the Monitor, post it on our Web site at himinfo.com. Each week, our team of experts answers a question that will appeal to the majority of readers. The elected question and the corresponding answer are delivered to your inbox every Friday.


TODAY'S TOPIC: Fracture care without follow-up

QUESTION: When a patient is seen in the ED for fracture or dislocation and the ED physician applies a cast or splint but does not provide any follow-up care, is it correct to assign the appropriate code from the 29000-29799 range? We have received conflicting information from consultants on this issue.

ANSWER: If the cast or splint is applied because the ED physician confirms the facture, but refers the patient to a specialist for fracture care, bill the appropriate casting/splinting code (29000-29799) along with the appropriate E/M level. Use modifier -25 on the facility E/M code. CPT codes 29000-29799 represent the work to create the immobilization device such as a double sugar tong splint or ulnar gutter splint. Look for documentation of materials used such as stockinette, Webril, plaster, or fiberglass.

However, if the ED physician confirms and treats the fracture, use the appropriate fracture-care code based on fracture site; the initial casting/splinting is included in the fracture care and codes (29000-29799) should not be billed separately. In either scenario, it is acceptable for the provider to bill for the casting or splinting supplies.


PAY PER VIEW: Follow the twists and turns of hernias to the right code.

The word "hernia" usually makes you think of an external bulge, either at the umbilicus or in the groin. In fact, there are many different types of hernias, varying in origin and location.

Click HERE to read more. The cost is $10. Briefings on Coding Compliance Strategies subscribers have free access via their online subscriptions.

ASK THE EXPERT: Should a patient's name be on every page of the medical record? In particular, if an organization uses a tri-fold record, is there a law requiring the patient's name on every page? What are the legal requirements?

Click here for the EXPERT'S answer.


Questions from readers are answered by a team of experts working in the APC area within the health care industry. Their answers are provided as advice. Readers should consult the federal regulations governing OPPS, related CMS sources, and with their local fiscal intermediary before making any decisions regarding the application of OPPS to their particular situations.


EDITOR'S CHOICE

Take two!

Hours that is, and join us for the audioconference that will get you ready to face 2004 with confidence. We're changing our usual format for "APC Task Force: How to Implement the 2004 Final OPPS Rule" and running it as a two-hour program. There is so much important information to share, and you'll probably have questions. We want to help you to start the new year off right!

We'll look for you on Tuesday, December 9 beginning at 1 p.m. Eastern. Bring your lunch, a pad of paper, the materials package we'll send, along with your questions.

To register or to learn more, CLICK HERE or call our Customer Service Team at 800-650-6787. Please mention source code EZ23521A when you call.

Are you ready to use the new 2004 ICD-9-CD codes?

We have just what you need to get ready. It's the 2004 ICD-9-CD Training Kit. You get a trainer's package with a plan to help educate staff on all of the changes, along with flyers and a Q&A section. You also get 10 coder handbooks, which include reference guides and clinical explanations for each new code so coders understand why and how each code should be applied. It's a steal of a deal at only $99. If you need more, we'll sell you additional coder handbooks in packages of 10.

Ordering is easy. Just CLICK HERE or call our customer service department at 800-650-6787. Be sure to mention Source Code EB23346A.




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