tci E/M Coding Alert - 2022 Issue Q1

Reader Questions: Code a Clavicle Fracture Fix Encounter Like This

Question: Encounter notes indicate that after a level-four office-evaluation and management (E/M) service for a new patient, the provider performs closed treatment of a clavicular fracture. How should I report this scenario? Washington Subscriber Answer: You should choose from the following codes for the fracture fix, depending on encounter specifics: 23500 (Closed treatment of clavicular fracture; without manipulation) 23505 (… with manipulation) Then, report 99204 (Office or other outpatient visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and moderate level of medical decision making. When using time for code...

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