# application of splint



## dbartlett (Jul 13, 2009)

Can we bill a procedure code (done in physician's office) for application of splint if it is applied by the nurse? Coder's desk reference says "the physician applies". Is that meant to be taken literally or is this a code that can be done by a medical professional under supervision of a physician?
And can anyone site a reference?
We are having an ongoing discussion as to whether or not splinting and casting codes must be performed by the provider to be billed on the HCFA
thanks
Diane Bartlett, CPC


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## abbycat333 (Apr 8, 2012)

If the "nurse" who applies the splint or cast happens to be a nurse practitioner, or physicians assistant, and has training in the application of splints etc and if the MD is present and available in the office where this is taking place, and of course has ordered the procedure, then its billable IF it meets the guidelines in the CPT for application of casts splints or strapping. That note will tell you the only cases in which casts splints or strapping can be separately billable is when its the initial treatment of a fracture or dislocation and not followed by any restorative or definitive treatment, OR if its within or past the global for fracture care, and the initial cast or splint or strapping has lost its ability to support, that is, broken, too loose, or the patient took it off. But of course, there are other reasons why a cast or splint or strapping might be done. It could be the patient has had bone removed and the leg is weak and needs support, or you could have a patient with a bad sprain of an ankle. Is this helpful? I used to code for an orthopedic surgeon.


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## estep (Apr 9, 2012)

*Cast Tech*

Could someone give me the guidelines to use when a Cast Tech is applying the cast.
Must have order, bill under the MD not PA.
Md must be on site to bill when the CAST tech is applying?


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