tci Medicare Compliance & Reimbursement - 2007 Issue 25

CODING: Don't Attract Carrier Scrutiny With The Wrong Diagnosis Code

You can bill fracture code only once.Wrong: A patient with a bone fracture still has the fracture until it's healed. So you should keep using the fracture-care code on your claims for every visit after your doctor sets the fracture.Right: You should use the fracture diagnosis only once. For every visit after the initial fracture care, you should use a post-fracture diagnosis from the V54.xx series."The patient shouldn't still have the fracture, but should be in the process of healing," explains Susan Posten, coder at the Houston Center for Spinal Reconstruction and Disc Replacement...

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