subsequent casts

solocoder

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I am reading conflicting opinions on whether or not we can charge for subsequent casts during a surgical global period. I was going by some advice from Margie Vaught that I read that says it is OK for Medicare and commercial payers, just add a 58 modifier, epecially for Medicare. I have done it, and been paid. But I have read on this forum where some say yes, some say no. Can anyone point me to some definitive documentation from Medicare (or WPS)?
I greatly appreciate any help.
 

thomas7331

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In the link below, Medicare defines the surgical package to include "All additional medical or surgical services required of the surgeon during the post-operative period of the surgery because of complications, which do not require additional trips to the operating room", and also lists casts as one of the miscellaneous services that are part of the package. So unless the subsequent casting is done in the OR because of a complication, I would understand this to mean it shouldn't be billed to Medicare.

https://www.cms.gov/Outreach-and-Ed...oducts/downloads/GloballSurgery-ICN907166.pdf
 

CodingKing

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What was the purpose of the cast change? For instance Fracture care only bundles in the initial cast and CPT guidelines allow separate reporting for cast changes. Typically that an issue with children as they grow so fast, get dirty and screw up their casts in ways they need to be done more than once.
 
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