tci ED Coding & Reimbursement Alert - 2004 Issue 9

READER QUESTIONS: Talk to Carrier for Splint Check

Question: When an emergency department technician or a nurse applies a splint and then the physician checks the application, how should I report this? One of our physicians told me I could bill for checking the application in addition to the evaluation and management (E/M) code.Delaware Subscriber Answer: Because the physician did not personally perform the service, this would fall under the category of "incident-to" services. CMS is clear in its stance that the incident-to provisions do not apply to services performed in the ED. Because of this strict guideline, the ED physician would need to apply the...

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