# 2nd cast during post op



## NIEVESM (Sep 14, 2009)

Hi everyone, my question for today,  Patient came for follow-up distal tibia fx short leg cast intact. No complaint. Dr. placed pt in a NEW short leg cast. Documentation do support charges for 99212, now should I bill the OV with mod 59 along with the new cast 29405? Thanks all for your help on advance.


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## RebeccaWoodward* (Sep 14, 2009)

I'm assuming your physician performed the initial fracture care.... the office visit would be a global service; therefore, not billable.  If the patient had a complaint, *not associated with the fracture care*, you could bill the appropriate office level with modifier 24 and the appropriate diagnosis.

Since this is a re-application of a cast, you would bill 29405 with modifier 58


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## NIEVESM (Sep 14, 2009)

Thanks so much Rebecca!


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## LynnS.321 (Sep 14, 2009)

I agree, and if the initial fracture care was itemized.  I still would not charge for the EM unless it is very well documented.  There is a component of EM in the cast application.  Hope this helps.
Lynn, CPC


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## NIEVESM (Sep 15, 2009)

Umm interesting! thanks Lynn orthopedic is kind of new to me I may have more question... thanks a lot for your help.


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## RebeccaWoodward* (Sep 15, 2009)

Mildred,

If your patient is being seen for the fracture care in addition to a *new problem*, unrelated to the fracture, it IS billable.

Example...

Patient returns for follow up visit of fractured wrist. (POST-OP)  Patient also complains of knee stiffness and pain (Unrelated to post op)...Your charges may look like this....

Follow up for wrist....99024 (post op visit) 
and 99213-*24* with knee related diagnosis 

As Lynn stated, if it is properly documented, you are able to legitimately  capture the non-related visit.


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## NIEVESM (Sep 15, 2009)

Thanks again Rebeca!


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## nyyankees (Sep 16, 2009)

where would I find any documentation on how to code casts and reapplications of said cast? thanks.


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