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Coding for replacement casts

  1. Default Coding for replacement casts
    Medical Coding Books
    I RECIEVED DENIALS FOR TWO OF OUR REPLACEMENT CASTS. IF THE PATIENT DAMAGED THEIR CAST DUE TO NEGLECT OR PUNCHING HOLES IN THE WALL, CAN WE NOT BILL FOR THE REPLACEMENT. I USED CODES FROM THE 29065-MODIFIER 58 AND Q4006.CAN WE NOT BILL FOR THESE?tHANKS!

  2. #2
    Location
    Capital Coders, Columbia, SC
    Posts
    145
    Default
    Replacement casts are typically reimbursable. I, too, append modifier 58 during the global period. I have encountered situations, also, in which the cast had to be replaced due to the patient's neglect or abuse. In this case, we held the patient finincially responsible for the replacement.


    Bill Hale, CPC

  3. #3
    Location
    Portland Metro Chapter
    Posts
    46
    Default non compliance
    When a patient is responsible for damage of a cast, I add the V code for non-compliance to my charge for the cast. V15.81 'Noncompliance with medical treatment'

    I use this when a patient removes his/her own cast , has obviously got the cast wet or jammed a pencil or other object inside the cast, etc.

    I don't use modifier 58 and we get paid.

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