Please read the following information regarding the billing for fracture care. It is important that you understand how your insurance will process our claim for your care services.
Fracture care is billed and coded as a surgical procedure according to the American Medical Association. Although no surgery may have occurred, the coding that we will use to bill your insurance will be designated as “surgery” by your insurance carrier.
Fracture care is billed by the diagnosis of the injury not by the method treatment. Once your physician has diagnosed you with a fracture, he or she will bill for fracture care, even if you are not treated with a surgical procedure, a cast, splint or other method.
Why Does This Happen?
When a physician bills for fracture care they have what is known as a "global period". The global period allows the patient to be seen for a certain number of days after the initial treatment or diagnosis of a fracture. Global periods are determined by the American Medical Association. The fees charged at the initial billing of fracture care include follow-up office visits within the global period only. There will be a charge for additional services, such as x-ray’s, if needed. Your insurance may require you to pay a co-pay at each visit in the global period.
Should you have any questions about fracture care coding, please contact our billing department once your insurance carrier has processed your claim at 317-888-1051.