tci ED Coding & Reimbursement Alert - 2008 Issue 11

Look for E/M Service on Your Fracture Claims, or Lose $$$

Additional E/M service almost a given, if you can ID 3 key components If you stop coding your fracture care claim with the appropriate CPT codes and necessary modifiers, you-ll likely cost the practice a reportable E/M service. "It is highly likely that a physician will perform an E/M with fracture care," reports Yvonne Mayer, CPC, senior coding analyst at One Park Fletcher in Indianapolis. "In the ED setting, [reporting] an E/M service is almost always justified in addition to any fracture care," explains Michael Lemanski MD, ED billing director at Baystate Medical Center in Springfield, Mass...

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