Understanding CPT Code 28510 – Billing for Fracture Care Follow-Ups

With regards to Standard Fracture Care, a patient’s fracture follow-up can be billed by the doctor.  The doctor must make sure, however, that the appropriate procedure codes as well as the ICD-9 code is used.  This pertains to the site of the fracture.  The follow-up care for closed fracture sites are covered by the CPT code 28510.  All, except those that involve the big toe.  Due to the details enclosed in this code, the need to perform site manipulations is no longer required if you plan to bill a patient’s follow-up care.  Because of the code 28510, it is immediately expected that a doctor will earn a hundred dollars for each patient.

A patient who comes in for a follow-up with regards to an injury such as a fracture is expected to spend time in a doctor’s clinic.  There is also a big possibility for them to inform you about certain medical issues they might have that would not be related to their fracture.  Doctors would not have to worry when this type of situation arises especially if they did not provide the fracture care initially.  As long as you document the visit correctly, you would be able to bill for the fracture follow-up and the additional concerns separately.  This is justified by the fact that the other concerns are not in any way related to the fracture.  The doctor just has to be very detailed about the consultation with regards to the proper procedure codes and the injuries addressed.

If ever the situation involves a patient who has multiple fractures comes for a follow-up, you can bill for each type of fracture.  For example, a patient has a fracture in his ribs, legs, and arms.  You can bill each site separately.  It is, however, crucial to document each fracture addressed and how long it took you to address it. 

Most fractures are billed to insurance companies of patients.  There are cases, however, wherein their fracture is work-related.  With this situation, Worker’s Compensation and the Personal Injury Protection Policy are applied.  The guidelines with this type of insurance may vary from state to state so it is important for a doctor to know about them before applying codes for the follow-up and any procedures done on the patient.  The important thing here is that the doctor gets paid for the care he has provided for the patient even if the initial check was done by another doctor.

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