Documenting for splints in the ED

[bananapeppers]

One of my full time job requires us to document splints after a tech performs it (put the order in, tech does it, you look at it, document it. There doesn't seem to be an issue since we have techs that do all of the splint work for us. 

 

I work at a rural ED part time where I'm "supposed" to do my own splints. Granted, the nurses can do them, but had an issue last week when a nurse told me that I needed "to do my own splints since the ED gets paid more when we do them." I think it was more out of laziness than anything - I spoke to the attending at that time and he thought it was ridiculous as he has never put a splint in the ED. 

 

I got an e-mail today from the ER group stating this:

 

"We regularly use Ace bandages, knee Immobilizers air cast and preformed splints as part of the treatment of these patients.  The application of these splints is billable in addition to the level of service for the visit.  The RVU value of splints is between .5 to 1.5 RVU.  For Medicare and Champus patients we must apply our own splints and straps to be able to bill.  Other insurers such as BC/BS, Aetna, and Cigna allow a nurse or tech to apply the splint and us to just document the post application Neurovascular exam."

 

Has anyone had issues with this at all? I have not had an issue until I came to work part time in this ED. I don't know of any other docs that do their own splints either - most of them don't have time for all that. 

[KMD16]

I do my own splint. And would rather do them myself for medical legal reason etc etc. This is a very important skills set that you're giving away for not doing your own splint. It's a very easy task. I would use the tech if you're provided one or the nurse to do the setup. Have your staff get the materials ready as you move on to seeing next patient and then return to splint.

[DogLovingPA]

In Urgent Care - I will sometimes put on a Velcro splint but the clinical staff does all the ortho glass splints.  The owner is however always drilling into us to make sure to check the splint afterwards for billing.

 

KMD16 brings up a good point though - I've probably lost that skill already (if you can consider me ever really having it after 2 splinting labs in school)

[EMEDPA]

if you "participate" in application you can bill at the provider rate for medicare etc. That might include holding up an arm or putting on the last ace wrap...I have seen this before. it's silly, but places that work on RVUs really chase that down. one of my jobs is rabid about it, the others don't care.