Replacement cast applications may billed along with supplies. It is helpful to append modifier 58 to the application as it is a planned or staged procedure during a post operative period. This generally happens on scheduled followup visits. The situation of the patient breaking the cast, however, adds a new twist. If the patient broke the cast due to negligence, he/she may need to be responsible for a new one. I recently had a carrier deny a re-application because at the bottom of the superbill was a tiny little note that said. "The pt's dog bit a hole in cast." ...Just something to consider.
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