1 / 12

Musculoskeletal Injuries

Musculoskeletal Injuries. Larry Halem MD, CPC VEP Regional Productivity Director. E+M Levels. Level 1 (99281): 0.6 RVU Level 2 (99282): 1.17 RVU Level 3 (99283): 1.75 RVU Level 4 (99284): 3.32 RVU Level 5 (99285): 4.9 RVU. Moderate Sedation.

golding
Download Presentation

Musculoskeletal Injuries

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Musculoskeletal Injuries Larry Halem MD, CPC VEP Regional Productivity Director

  2. E+M Levels Level 1 (99281): 0.6 RVU Level 2 (99282): 1.17 RVU Level 3 (99283): 1.75 RVU Level 4 (99284): 3.32 RVU Level 5 (99285): 4.9 RVU

  3. Moderate Sedation • The importance of billing moderate sedation is the length of time • Greater than 10 minutes minimum. • Time begins from administration of medications to when you leave the room • You must also document if you are performing the procedure and the sedation or just the sedation alone

  4. Moderate Sedation • If you perform the procedure and sedation: • Moderate sedation less than 5 year: 0.67 • Moderate sedation greater than 5 year: 0.35 • Each additional 15 minute block: 0.31 • If someone else performs the procedure while you perform the sedation: • Moderate sedation less than 5 year old: 2.63 • Moderate sedation greater than 5 year: 2.15 • Each additional 15 minute block: 1.63

  5. Fracture care • Documenting care of the fracture is important • A complete ICD-10 diagnosis is important to code appropriately • Manipulation is a key component to fracture care and the number of RVU’s generated • Follow up for your fracture must be greater than 48 hours to get reimbursed for the care you provided • This is the preoperative portion of the patient’s care

  6. Fracture care • Clavicle Fracture • Without manipulation: 0.63 • With manipulation: 0.94 • Humeral Fracture • Without manipulation: 0.87 • With manipulation: 1.2

  7. Fracture care • Radial shaft or radial/ulnar shaft fracture: • Without manipulation: 0.71 • With manipulation: 1.3 • Distal radius fracture: • Without manipulation: 0.8 • With manipulation: 1.3

  8. Fracture care • Metacarpal fracture (coded based on each bone): • Without manipulation: 0.7 RVU • With manipulation: 0.8 RVU • Finger Fracture: • Without manipulation: 0.5 RVU • With manipulation: 0.8 RVU

  9. Fracture care • Ankle Fracture (specify area of ankle being reduced): • Medial malleolus: • Without manipulation: 0.86 RVU • With manipulation: 1.2 RVU • Lateral malleolus: • Without manipulation: 0.81 RVU • With manipulation: 0.85 RVU

  10. Dislocations TMJ dislocation: 0.92 Elbow dislocation: 9.49 Shoulder dislocation: 8.2 Nursemaid elbow: 2.45 Finger dislocation: 7.2 Patella Dislocation: 9.4 Ankle Dislocation: 10.4 Toe Dislocation: 2.5

  11. Splints • You can only bill for splints that are made and assembled in the ER. • Document who applied the splint (some insurances will only pay if physician applies) • Document the splint material • Note must document neurovascular status after splint applied • Ace wraps, pre-made wrist splints, buddy taping, and knee immobilizers can no longer be billed

  12. Splints Finger splint: 0.82 Short arm splint: 1.13 Long arm: 1.71 Long or short leg: 1.43

More Related