Wiki Casting Supplies

[andijo]

Just wondering if anyone has any documentation as to what can be billed and what can not as far as Ace Bandages, Casting Tape.... What I understand is you can NOT bill for supplies when the physician does anything else on that DOS. But I read other people's suggestions and it say we can bill them but they are patient responsibility because they are something that can be purchased at the store. Also we are billing out A4590 for cast tape and A6450 for ace bandages would that be correct?
Any general information on these would be great.

 

[CodingKing]

Many of the supplies involved in casting and strapping can be bought OTC, that has no impact as to whether you can bill for it or not. They are supplies incidental to another service. If no other service is being done what are the supplies for in the first place. If casting and strapping is the only service provided and its not fracture care bill for the service code for what casting and strapping procedure is performed.

 

[andijo]

If a patient comes in during a post op period and we apply another cast/splint, can we bill for that or is it still included with the fx care?
-- Also if a patient comes in with Edema and we wrap with an Ace and bill an OV, is that ace included in the ov? Because if I bill Medicare for the Ace they deny it as PR96 not CO97.

 

[CodingKing]

CPT guidelines are a good source

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The listed procedures apply when the cast application or strapping is a replacement procedure used during or after the period of follow-up care, or when the cast application or strapping is an initial service performed without a restorative treatment or procedure(s) to stabilize or protect a fracture, injury, or dislocation and/or to afford comfort to a patient. Restorative treatment or procedure(s) rendered by another individual following the application of the initial cast/splint/strap may be reported with a treatment of fracture and/or dislocation code.
An individual who applies the initial cast, strap, or splint and also assumes all of the subsequent fracture, dislocation, or injury care cannot use the application of casts and strapping codes as an initial service, since the first cast/splint or strap application is included in the treatment of fracture and/or dislocation codes. (See notes under Musculoskeletal System, page 98.) A temporary cast/splint/strap is not considered to be part of the preoperative care, and the use of the modifier 56 is not applicable. Additional evaluation and management services are reportable only if significant identifiable further services are provided at the time of the cast application or strapping.


If cast application or strapping is provided as an initial service (eg, casting of a sprained ankle or knee) in which no other procedure or treatment (eg, surgical repair, reduction of a fracture, or joint dislocation) is performed or is expected to be performed by an individual rendering the initial care only, use the casting, strapping, and/or supply code (99070) in addition to an evaluation and management code as appropriate.

Listed procedures include removal of cast or strapping.
(For orthotics management and training, see 97760-97762)