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Thread: 2nd cast during post op

  1. #1

    Default 2nd cast during post op

    AAPC: Back to School
    Hi everyone, my question for today, Patient came for follow-up distal tibia fx short leg cast intact. No complaint. Dr. placed pt in a NEW short leg cast. Documentation do support charges for 99212, now should I bill the OV with mod 59 along with the new cast 29405? Thanks all for your help on advance.
    Mildred Nieves, CPC

  2. #2
    Join Date
    Apr 2007
    North Carolina


    I'm assuming your physician performed the initial fracture care.... the office visit would be a global service; therefore, not billable. If the patient had a complaint, not associated with the fracture care, you could bill the appropriate office level with modifier 24 and the appropriate diagnosis.

    Since this is a re-application of a cast, you would bill 29405 with modifier 58
    Last edited by RebeccaWoodward*; 09-14-2009 at 09:11 AM. Reason: spelling

  3. #3


    Thanks so much Rebecca!
    Mildred Nieves, CPC

  4. #4


    I agree, and if the initial fracture care was itemized. I still would not charge for the EM unless it is very well documented. There is a component of EM in the cast application. Hope this helps.
    Lynn, CPC

  5. #5


    Umm interesting! thanks Lynn orthopedic is kind of new to me I may have more question... thanks a lot for your help.
    Mildred Nieves, CPC

  6. #6
    Join Date
    Apr 2007
    North Carolina



    If your patient is being seen for the fracture care in addition to a new problem, unrelated to the fracture, it IS billable.


    Patient returns for follow up visit of fractured wrist. (POST-OP) Patient also complains of knee stiffness and pain (Unrelated to post op)...Your charges may look like this....

    Follow up for wrist....99024 (post op visit)
    and 99213-24 with knee related diagnosis

    As Lynn stated, if it is properly documented, you are able to legitimately capture the non-related visit.

  7. #7


    Thanks again Rebeca!
    Mildred Nieves, CPC

  8. #8
    Join Date
    Apr 2007
    Long Island/New York


    where would I find any documentation on how to code casts and reapplications of said cast? thanks.

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