can a dr bill this?

[deidrahofer]

Established patient-

follow-up of clubfoot

dr. removes cast, remanipulates the foot, and applies a new cast.

Can the dr. bill for the office visit as well as 29450?

Thanks

Deidra

 

[spirving]

Depends on what he billed for the initial fracture visit. If he billed a fracture care code then this visit will probably fall within the global period. But if he chose to break it out visit by visit, as long as he meets the required elements of an office visit I'd say he can bill it with a -25 mod probably.

 

[zaidaaquino]

During the previous visit, was the patient scheduled to have the cast removed during the follow up? If that's the case, and there was nothing "significant, separately identifiable" that would warrant a modifier -25 for the E&M service, then the doctor would not bill an E&M service.

Zaida, CPC

 

[eblanken]

I would say no because club foot casting is a series of staged casts to correct a deformity. The physician knows when he puts on the first cast that he will need to remove and replace the cast at a subsequent visit. Also if a tenotomy was done prior to any of the casting then you will need to append modifier 58 to the cast application.

FYI this is not a fracture care issue.