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Thread: Please help code this!

  1. #1

    Angry Please help code this!

    AAPC: Back to School
    Patient is seen in the office today for evaluation of the right ankle. He underwent surgery with Dr. xxxx in Denver approximately 5 weeks ago.

    Patient has a concern over getting his cast wet. He is scheduled to see Dr. xxx later this week in Denver.

    PHYSICAL EXAMINATION: On examination, the cast is removed today in the office. The incisions are benign appearing. There is no sign of infection or rash. The right ankle is in a neutral position. It overall appears to be doing well at this point.


    TREATMENT AND RECOMMENDATIONS: The patient's right ankle was overwrapped with an Ace wrap and placed back into the Cam boot.

    He will follow up as planned with Dr. xxx later this week. He will call or return sooner if there are any problems or concerns.

    My question is what cast removal code would be reported to the Worker Comp carrier?

  2. #2


    Is there a 90 day Global for the Surgery that was done? If yes, then I believe this visit is Post-Op and the cast removal is bundled.

  3. #3
    Join Date
    Apr 2007


    Are you billing for a Doctor in the same groupt as Dr. xxxx? If so, it falls under the global period.
    TJ Smith, CPC
    Cheyenne Physicians Group
    Cheyenne, WY

  4. #4


    different surgeon than the one whom preformed the procedure. physician is not performing post -op. Thanks for any help or suggestion.

  5. #5


    Ok, so if you are saying your Doctor is under a different tax ID# than the one that performed the surgery, then yes...you can charge for this visit. I would charge an E&M with 29700. I would also attach the chartnote to claim.

  6. #6
    Join Date
    Apr 2007


    you will also need a 25 modifier on the E/M visit
    Mary, CPC, CANPC, COSC

  7. #7


    Thank you for your help!

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