Wiki Casting

[pittiemom2722]

Some insurances will pay no problem without a modifier on a subsequent cast after the initial application but some deny as global to the initial fracture care. Does anyone add a modifier routinely to the casting codes during the 90-day follow up? Modifier 58?

Thanks!

 

[nrichard]

This can be a sticky stituation.

I've always subscribed to the theory, to bill for the fx care and the initial cast (which usually denies as included) other than that we did not bill for the casting again during the global period, unless the patient went to a different sort of cast such as a regular cast to a water proof cast, or it was a child who played sports and was going to a sturdier cast (with external support) we didn't bill the cast again. Of course I could be wrong, this is only my two cents. Also too if these visits are for routine, fx care follow up I'd be hesitant to putting -58 on these routine cast changes.

 

[scooter1]

Of course the initial cast is included in fracture care, but the subsequent casts should be payable. . . . . . . I haven't heard any of our billers saying they aren't getting paid.