Wiki 2nd cast during post op

[NIEVESM]

Hi everyone, my question for today, Patient came for follow-up distal tibia fx short leg cast intact. No complaint. Dr. placed pt in a NEW short leg cast. Documentation do support charges for 99212, now should I bill the OV with mod 59 along with the new cast 29405? Thanks all for your help on advance.

 

[RebeccaWoodward*]

I'm assuming your physician performed the initial fracture care.... the office visit would be a global service; therefore, not billable. If the patient had a complaint, not associated with the fracture care, you could bill the appropriate office level with modifier 24 and the appropriate diagnosis.

Since this is a re-application of a cast, you would bill 29405 with modifier 58

 

[NIEVESM]

Thanks so much Rebecca!

 

[LynnS.321]

I agree, and if the initial fracture care was itemized. I still would not charge for the EM unless it is very well documented. There is a component of EM in the cast application. Hope this helps.
Lynn, CPC

 

[NIEVESM]

Umm interesting! thanks Lynn orthopedic is kind of new to me I may have more question... thanks a lot for your help.

 

[RebeccaWoodward*]

Mildred,

If your patient is being seen for the fracture care in addition to a new problem, unrelated to the fracture, it IS billable.

Example...

Patient returns for follow up visit of fractured wrist. (POST-OP) Patient also complains of knee stiffness and pain (Unrelated to post op)...Your charges may look like this....

Follow up for wrist....99024 (post op visit)
and 99213-24 with knee related diagnosis

As Lynn stated, if it is properly documented, you are able to legitimately capture the non-related visit.

 

[NIEVESM]

Thanks again Rebeca!

 

[nyyankees]

where would I find any documentation on how to code casts and reapplications of said cast? thanks.