tci ED Coding & Reimbursement Alert - 2001 Issue 5

Reader Question: Fractured Medial Orbit Wall

Question: A patient presented with an eye injury from a softball. CT results showed medial orbit wall fracture. According to the documentation, the ED physician prescribed Amoxicillin for 10 days, and ice to keep swelling down. The physician referred the patient to an eye specialist for follow-up. Can 21400 be used in addition to an E/M code? If not, when is 21400 appropriate?Sandy ColsonSt. Joseph Healthcare, Albuquerque, N.M.Answer: If all the physician did was examine the eye, prescribe the medication and refer the patient (there is no mention of treatment of the orbit wall fracture), code...

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