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Click here for more sample CPC practice exam questions and answers with full rationale

Billing for fracture care

I am having a hard time trying to research this question, hoping someone here has some insight!

We have a physician that thinks it is illegal to bill out fracture care and an E&M code on a follow up visit after he sent the patient out for a test to confirm the fracture (i.e. MRI, CT).. In other words, he thinks the correct billing would be an e/m code on visit 1 and then only a fracture care code on visit 2.

Does anyone know if it is illegal to bill an e/m & fracture care code on visit 2? Part of me feels like this falls under "physician preference" and there isn’t legality to the issue. But may there is a rule out there by CMS or otherwise that I am just not finding.

Thank you in advance for any guidance!

Medical Billing and Coding Forum