Medicare Compliance & Reimbursement

Think Q4050 is out of your reach? Think again. If you aren't billing Q codes to Medicare for your casting supplies, you could be missing out on up to $50 per claim. Suppose a practitioner in your office applies the cast to a patient's fractured limb. You report the CPT code, and you're all set, right? Not so fast. You'll be writing off significant reimbursement without also reporting the appropriate casting code from the 29000--"29086 (body and upper extremity) or 29305--29450 (lower extremity) series, based on the cast's location and other specifics. Depending on payer preference, choose the supply code from HCPCS' more general "A" section or more specific "Q" section. For a plaster cast, some possible codes include A4580 and Q4005. For fiberglass, you might report A4590 or Q4006, among other codes. Q Codes May Sail Through Medicare No code exists for a combination plaster and fiberglass cast. If [...]