tci ED Coding & Reimbursement Alert - 2020 Issue Q4

You Be the Coder: Can You Report E/M With Fracture Care?

Question: In last month’s issue, you discussed the difference between fracture care and comfort care, and mentioned that the physician can report an E/M code for comfort care. What about if we confirm that fracture care was performed? Can we bill an E/M with that? Arizona Subscriber Answer: Yes, barring any payer-specific edits, you can typically report an E/M code (99281-99285) along with a fracture care code. However, keep in mind that you’ll need to append a modifier to the E/M code, and, in most cases, that will be modifier 57 (Decision for surgery) instead of modifier...

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