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Thread: Cast application OK if staff performing?

  1. #1
    Join Date
    Apr 2007

    Default Cast application OK if staff performing?

    AAPC: Back to School
    Can an orthopedic surgeon code for cast application if a medical assistant or other staff does the actual application?

    This question came up with some orthos who didn't believe it was codeable unless they themselves did the app. I always thought that, provided that all other conditions were appropriate (i.e., it's not the initial app in a fracture care, if done by an NP/PA it's billed with the NP/PAs provider number, etc.), it's completely appropriate to code the app, even when staff is doing it.

    I checked Medicare's Benefit Policy Manual, sections 60-60.1 (the incident-to section) and 100 (Surgical Dressings, Splints, Casts, etc.), and I'm interpreting it, along with my past experience, as "yes, you can code for that". But I admit the question floored me--any thoughts out there?

    Thanks in advance!

  2. #2


    When we had a PA that did cast application we would bill under the PA's NPI and it was always payable.

    Not to sure about a medical assistant or staff applying the cast. I know the staff would remove a cast but not sure about applying the cast if doc can bill for that when he didn't do it.

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