Cast Application

Renea

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I know that there is no charge for the first cast but cast supplies are still billable. If the surgeon I work for puts on a splint or bulky dressing in the operating room and then a few days later the patient comes into the office for a cast can I bill for the cast and cast supplies? I know I could if he had applied the splint in our office and then the patient came back for the cast but since it was applied at the facility I'm not sure.
 

ksobota

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Yes you can bill for the cast application not done during the surgery. Use modifier 58 with the cpt code applicable to location and length of the cast. Usually they'll just place a splint during the surgery to allow for swelling. When that has gone down they'll put on the cast so it's staged. You can also bill the Q40xx (I think that's the range off the top of my head) for casting supplies.
 
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Cast supply billing a few days after surgery

What we have been told is the same as ksobota, that if the patient goes home after surgery with a dressing and not a cast so that swelling can go down before a cast is put on, when the patient comes to the office the following week and has the initial cast put on, you can bill for the supplies, but not the cast application because it is bundled in the surgery, the supplies are not bundled and are separately billable. I, however, cannot find this in writing anywhere and that is what I need. Can anyone help? Thank you, Jean
 
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