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Casting questions again

  1. #1
    Modesto, CA; Central Valley Chapter
    Default Casting questions again
    Medical Coding Books

    I just can't get the hang of these casting guidelines and when EMs can be billed.

    patient injures thumb in Nov 07, is still symptomatic after splint was removed. Provider does exam and places patient back in thumb spica cast. He wants to code cast application, cast supplies and EM, is the EM appropriate?

    Scenario 2:
    patient injures hand, is seen in ER and receives sutures & splint, and referred to ortho for consult. Patient sees ortho provider, splint removed injuries assessed. There are fractures. Splint is reapplied. Again provider wants to code cast application, cast supplies and EM, is the EM appropriate?

    Tina Reich, CPC, CPC-I, CEMC

  2. #2
    In first scenario I would say no to E/M cause he is still symptomatic.
    Second one if ortho removed and your provider had to reapply then yes I would think you should bill EM again.

  3. #3
    Greeley, Colorado
    Scenario 1 - Patient is now outside of global for fracture care, so you can code E/M -25, cast application and supplies.

    Scenario 2 - Why not code fracture care (unless your provider is not going to assume care for the fracture)? Follow up visits: cast re-application can be coded as well as supplies.

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