tci ED Coding & Reimbursement Alert - 2016 Issue 9

Reader Question: Don't Cast Too Wide a Net on "Incident To" Cast Applications

Question: A 60 year-old presents to the ED and is found to have a fracture of the distal ulna after a fall. The emergency physician orders x-rays, and after interpreting the films, makes the treatment decision to have the forearm casted without reduction. The actual cast is applied by an orthopedic tech without physician involvement. An EM level 99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; an expanded problem focused examination; and medical decision making of moderate complexity…) was reported, but can we...

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