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Orthopedic Coding Alert

Reader Questions:

Insurers Don't Subject Boot to Casting Guidelines

Published on Fri Sep 10, 2004

Question: Can we charge for closed treatment of an ankle fracture along with a walker boot (L2114)? We realize that insurers include the initial "strapping or cast" in closed fracture treatment, but because the patient can reuse the boot, we aren't sure whether it falls under the strapping/casting guidelines.

Michigan Subscriber Answer: Because the patient can reuse the walker boot, insurers consider it durable medical equipment (DME) and don't include it in the casting and strapping guidelines.
 
Therefore, you can report L2114 (AFO, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment) in addition to the global fracture treatment code (e.g., 27530, Closed treatment of tibial fracture, proximal [plateau]; without manipulation).
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