Wiki Supplies and casts

[Carol's Page]

I need some help with a coding question. If a cast application, splinting or strapping is provided as an initial procedure in which no surgical procedure is performed (such as casting for a sprained ankle, etc.) what would you bill?
I have been doing the E&M and a supply code but not the cast code on the initial visit. I have been told that some charge a cast code also. What does everyone think?

Carol, CPC

 

[Lisa Bledsoe]

E/M with modifier -25 and the cast/splint application code and the appropriate Q code for supply.

 

[Carol's Page]

Thanks Lisa. I have also gotten documentation from our state Medicaid office (TN) that says they do not allow the application of the cast code on the first visit. Looking like it may be a payer specific problem.

 

[michellelgrd]

i dont know about in TN but LA medicaid doesnt pay for casting after a patient reaches a certain age either