Outpatient Facility Coding Alert - 2008 Issue 11
Look for E/M Service on Your Fracture Claims, or Lose $$$
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Article Overview
This premium article reviews fracture care claims in the context of a separate evaluation and management service, with emphasis on emergency department documentation and claim reporting. It is aimed at coding professionals who need to understand when encounter notes may support both procedure and E/M reporting, along with the broad coding elements involved in a fracture scenario. The article also touches on diagnosis reporting and injury circumstance reporting used to support the claim.
Why This Topic Matters
Fracture encounters can involve both procedure reporting and a distinct E/M service, and overlooking that possibility may affect claim completeness and reimbursement. The article helps readers understand the documentation and reporting areas to review when assessing these encounters.
What You Will Learn
- How fracture care encounters may also involve a separately reportable E/M service
- What types of documentation are reviewed when evaluating an encounter for additional E/M reporting
- How an emergency department fracture scenario is presented in the article
- Which broad reporting categories are associated with the fracture claim, diagnosis, and injury circumstances
Who Should Read This
- Professional coders
- Billing specialists
- Emergency department coding staff
- Compliance and reimbursement professionals
- Physician practice coders
Codes Discussed
Modifiers Discussed
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