Fracture Treatment and Teaching Physician Requirements

Fracture Treatment and Teaching Physician Requirements

November 15, 2018

Question:
Our physicians teach residents in an academic medical center.  Often the residents see fracture patients in the ED and reduce fractures without the attending physician present.  When the patients follow up with the teaching physicians in the office, they want us to report the global fracture codes that say “without manipulation”, because no one has billed yet for a global fracture service.  Is this allowed?

Answer:
Just because no one billed for the global fracture service in the ED, it is not correct for the teaching physician to report a “without manipulation” global fracture code.  The fracture treatment was performed by the resident, and the manipulation service would have been reportable if the teaching physician had gone to the ED to participate.  The physician will receive credit for the post-operative care he or she performs by reporting itemized E/M visits when the patient is seen in the office.

*This response is based on the best information available as of 11/15/18.