Wiki Intraoperative application of casts or splints


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At the end of many orthopedic surgeries, not just fracture/dislocation, a cast or splint may be applied to provide support to the injured limb post operatively. I have always in the past considered this to be inclusive in the procedure and bundled with it. Its usually applied to a still sedated patient, while still on the table, and may or may not be applied by the operating surgeon, so I never billed for this separately. Suddenly after 20 years of thinking this way, I am being told by another doc's practice that it can be separately billed for surgeries other than for treatment of a fracture or dislocation. They are telling me that the coding guidelines in the cast/splint application section concerning when you can bill separately apply only to fracture and dislocation global care. So, if a patient had a Bostrum repair for a chronic ankle sprain and ligament laxity, and while still in the OR, a splint were applied to support the ankle repair, the application could be separately billed? Egad, what happened to the surgical global? Wouldn't this be normally a part of the procedure, since the operation would be disrupted right away without some kind of support? Would appreciate your thoughts.
I'd really like to know the answer to this question too. One of my doctors says it IS seperately billable and he has always been reimbursed for it. I'd sure like to know what is correct.
If the codes are bundled per a CCI edit, they are not billable separately. That is the only way you would be able to confirm the ability to code both procedures.