# Fracture care



## daniel (Nov 25, 2008)

Seen this powerpoint on the internet. Copied one of the slides and pasted it below. Question is can you bill for these services in this order. What threw me off was this example is saying you can bill a 99213 for the removal of the cast. Isn't this included in the 90 day global of the 25500. 

Opions Please.


Respectfully
Daniel, CPC







Example:  Healthy 5 year old female comes in after FOOSH injury with nondisplaced torus fx of distal radius on x-ray, normal exam except for tenderness over distal radius

On initial visit:  99213 visit (0.67 RVUs) with CPT 29125, application of short arm splint (0.59 RVUs) with total RVUs on initial visit:  1.26 RVUs

THEN patient f/u done 3-4 days later after swelling has decreased and 99213 coded (0.67 RVUs) and CPT 25500, closed treatment of radial shaft fracture without manipulation (2.51 RVUs) with total of :  3.18 RVUs

Follow up in 3 weeks with removal of cast, 99213 (0.67 RVUs)

Total of 5.11 RVUs for treatment and orthopedic referral avoided 
2008 RVU values (increased 0.82 RVUs for CPT 25500 vs 2006 values)


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## mbort (Nov 25, 2008)

daniel said:


> Seen this powerpoint on the internet. Copied one of the slides and pasted it below. Question is can you bill for these services in this order. What threw me off was this example is saying you can bill a 99213 for the removal of the cast. Isn't this included in the 90 day global of the 25500.
> 
> Opions Please.
> 
> ...




It appears that the website that you obtained this information is incorrect.
For "The Follow up visit in 3 weeks" the patient is in global and the 99213 would not be applicable.


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## JodiSpriet (Sep 10, 2010)

*Removal of cast*

I work in a family practice office and a patient came in who had been seen elsewhere for a fracture.  He comes to our office and he is a new patient.  The patient is not electing to do anymore follow up.  We took off the short arm cast and gave him a brace.  I have looked and looked and do not see a code for removal of a short arm cast.  Would we even be able to bill it out?  Can we only do the new patient E/M and the brace?

Thanks,
Jodi


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## Bella Cullen (Sep 10, 2010)

jodihacker said:


> I work in a family practice office and a patient came in who had been seen elsewhere for a fracture.  He comes to our office and he is a new patient.  The patient is not electing to do anymore follow up.  We took off the short arm cast and gave him a brace.  I have looked and looked and do not see a code for removal of a short arm cast.  Would we even be able to bill it out?  Can we only do the new patient E/M and the brace?
> 
> Thanks,
> Jodi



yes, in your case I would bill a new pt visit and the brace. 

In the other case I agree with mbort.


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