AAPC - Back to school
Results 1 to 6 of 6

Thread: Treating fractures and casting

  1. #1
    Join Date
    Apr 2007
    Modesto, CA; Central Valley Chapter

    Default Treating fractures and casting

    AAPC: Back to School
    I have not worked a lot with fractures and casting so I am hoping someone can verify for me if I have this scenario correct....

    Patient comes in with nondisplaced distal radius fracture:

    The doctor codes:
    25600 - fracture care without manipulation
    29075 - application of cast
    office consult
    Q4010 - cast supplies

    My thought process is that he cannot code both the fracture care and the application of cast/casting supplies; he should only be coding the fracture care.

    Is this correct?

    Tina Reich, CPC, CPC-I, CEMC

  2. #2


    You were correct. When billing a fracture package the application of the cast is included in the fracture care code (25600). So you would code the fracture care code and the cast supplies. You can find this info under "Application of Casts and Strapping" in the CPT book.

    I also watched a webinar last week on Zimmer's website that discussed whether it was appropriate to bill an E/M code with the fracture code. It basically stated if this was the only reason for the visit (only one dx) it would be inappropriate to bill the E/M code. It stated if the patient had more than one dx code you could bill this and append the other dx code to the E/M code. I just learned of this and am still trying to find more info on it.

    Hope this was of some help.

  3. #3


    Correct Tina - You can however bill the Fx care code w/ out manipulation and the supply code.
    Have a good one!

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default E&M plus Fx care

    Don't know if this is really a consult vs a new patient ... but ... assuming the patient has never been seen before for THIS fracture ... you CAN bill an E&M visit with a 57 modifier (decision for surgery).
    F Tessa Bartels CPC

  5. #5
    Join Date
    Apr 2007
    Modesto, CA; Central Valley Chapter


    Even when the fracture care code states without manipulation?
    Tina Reich, CPC, CPC-I, CEMC

  6. #6


    Even though there is no manipulation the cast application is still included in CPT 25600. I looked up this code in Ortho Coding Companion and it states "According to CPT guidelines, cast application or strapping (including removal) is only reported as a replacement procedure or when the cast application or strapping is an initial service performed without a restorative treatment or procedure." Even though no manipulation this code is still considered to be restorative treatment.

    Basically I take this to mean that if you bill the fracture package it is billed with the supply code. This would have a 90 global. If patient comes in for a cast change you would bill the application of the cast and the supplies. (with 58 modifier)

    Or the physician can decide to itemize bill in which case you would bill appropriate E/M with the application code and the supplies. There would be no global period. When patient comes in for cast change we bill cast application and supplies. We usually figure out whether to bill the fracture pkg or itemize depending on how many times dr anticipates seeing the patient.

    Hope this wasn't confusing sometimes I tend to ramble!
    Last edited by cbheusman; 04-14-2008 at 06:21 PM. Reason: correction

Similar Threads

  1. treating family
    By melonie_lockard@yahoo.com in forum Medical Coding General Discussion
    Replies: 5
    Last Post: 05-24-2014, 05:36 PM
  2. Treating Patients Outside of the
    By CJoy0724 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 03-04-2010, 02:17 PM
  3. Treating Fractures in ED
    By Mindy Davis in forum Emergency Department
    Replies: 6
    Last Post: 11-25-2009, 03:22 PM
  4. wrist fractures (radius and ulna fractures)
    By Jamie Dezenzo in forum Orthopaedics
    Replies: 2
    Last Post: 06-23-2009, 11:10 AM
  5. medical dx vs treating dx
    By Networker3412 in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 05-14-2008, 04:57 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.