I am an orthopedic coder needing some clarification. A patient is initially seen in the ED with a femoral neck fracture and the ED provider is requesting Ortho consultation; a hospitalist accepts them as an admit. The Ortho provider consults and determines that the patient needs to be taken to the OR for a hemi/total arthroplasty, he also reviews labs done and reports patients INR is too high to safely take patient to surgery. The Ortho provider see’s the patient for another 3 subsequent inpatient visits monitoring the patients INR and providing Vitamin K and managing this patient with another hospitalist/cardiologist in consultation as well. Can we bill those subsequent visits after the decision for surgery was made on his initial consultation? If the orthopedic provider was not providing any care regarding his INR except for coming in to the patients room and reviewing labs and the patient, would we be able to in that circumstance? We don’t do much inpatient visits in Orthopedics so I cant say Im definitively comfortable in this situation.

thanks for the help in advance