“What is the date that fracture care begins? Is it the date of the injury or is it the date of service when the doctor makes the decision for closed management of a fracture?”
When talking about the global period for fracture care, it definitely does not begin with the date of the injury or the date that the fracture occurred. When addressing “closed management of a fracture” which is described as “closed treatment of the fracture” based upon the CPT definitions, this CPT code set has the same Global Period of any CPT code that is classified as a “Major Surgical Procedure.” Any CPT code that has a Global Period of “90” days is classified as a “Major Surgical Procedure.” For a Global Period of “90” days, the Global Period includes the actual day that the PROCEDURE (ie. closed treatment of the fracture without manipulation) was performed, the day BEFORE the procedure was performed AND the next 90 consecutive postoperative days. Thus, in reality, “90” days really means “92” days. So, the date that “fracture care” begins is the day before the date of service when the “fracture care” was performed and billed.
This is my opinion.
Michael G. Warshaw
DPM, CPC
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