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.