decisionhealth Newsletters, Part B News - 2016 Issue 7 (July)
Splinted before surgery? If you’re admitted, the office charge goes away
Subscribe or sign in to view the full article.
Article Overview
This premium coding article explains the reimbursement and billing implications of office-based fracture splinting when the patient is admitted to the hospital and later undergoes surgery. It is aimed at physicians, orthopedic practices, and medical billers who need to understand how same-day admission and operative care can affect whether office services, materials, and related evaluation services are separately payable. The discussion touches on Medicare billing, global surgical payment concepts, and the use of evaluation and management modifiers in this context.
Why This Topic Matters
These scenarios can determine whether a practice can separately bill for preoperative office services or whether the work is shifted to the hospital/surgical payment. Understanding the billing relationship between office care, admission, and surgery helps reduce claim denials and improper duplicate billing.
What You Will Learn
- How same-day hospital admission can affect payment for office-provided fracture care
- How preoperative splinting may relate to surgical billing and global payment concepts
- When office evaluation and management services may remain separately reportable
- How splinting materials fit into the billing picture in this scenario
Who Should Read This
- Physicians
- Orthopedic practices
- Medical billers
- Coding specialists
- Revenue cycle staff
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.


Quick, Current, Complete - www.findacode.com