Wiki Fracture care 101

[bethb]

Looking for clarification with regards to global fracture care and cast changes (I'm newer at this--but learning!)

Global fracture care is 90 days and includes initial casting and/or strapping...

Can re-casting [due to a loose cast, mal-fitting cast] be billed separately during the global fracture care period?

Example: Fracture care code billed out for patient with closed fracture for date of service 3/1/2017

Pt returns for a re-check on 4/2/2017, and the cast is loose. Dr. changes cast because of looseness. Is the cast change able to be billed?

Thank you!

 

[Kisha]

sorry, yes you can report the code during the global period.

 

[CodingKing]

I've always been told that replacements are separately reportable and only the initial casting/strapping is bundled. Especially common for cast changes for children. AMA guidelines agree (Of course its possible payer can have overriding guidelines):

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.

 

[daedolos]

Billed a recast last week, Monday, and today. I was told (a third time after a query) that if the dictation documents a feasible reason like a loose or malfunctioning cast, you can bill the appropriate cast code with the left or right modifier if applicable. Include the original Dx with the proper 7th digit but do NOT put an E/M code. I'm sure each office runs things differently though.

Peace
@_*