I run around in circles all day and my brain has meltdowns. I figure if I ask questions in here and get replies, I can reference back later for when I have another one.
1. When coding for waterproofing casts, I see some of my providers coding A4590 and others Q4050. There is a pricing difference with the codes that I have noticed. Is there a specific one to use or a preferred one? Or is it just by insurance? Do any of you have the insurance breakdown if that is what it is?
2. Some examples that I would like help with:
A. Pt comes into ER, ER sees fracture send to ortho for referral, Ortho decides casting is needed. They place a waterproof aqua cast WITHOUT reduction. (Do you only code office visit/ fracture care, with the casting materials? the application is included correct?)
1. Now that same scenario WITH reduction - you code the reduction with the materials only? Application is included in the reduction procedure, right?
B. Pt comes into office, for the subsequent encounter of fracture after reduction and a splint has been applied previously, this visits they place waterproof cast. Do you code the office visit (with 25) and then the casting application and materials? Or no office visit if they did a reduction and splinting prior for global?
2. If they had a cast placed the first time and are back to have a replacement, you only code the office visit with the casting materials, correct?
Just trying to understand as my providers are all different and they place every single code on their forms, and I am trying to make a spreadsheet to help clear some of these up. Thank you all.
1. When coding for waterproofing casts, I see some of my providers coding A4590 and others Q4050. There is a pricing difference with the codes that I have noticed. Is there a specific one to use or a preferred one? Or is it just by insurance? Do any of you have the insurance breakdown if that is what it is?
2. Some examples that I would like help with:
A. Pt comes into ER, ER sees fracture send to ortho for referral, Ortho decides casting is needed. They place a waterproof aqua cast WITHOUT reduction. (Do you only code office visit/ fracture care, with the casting materials? the application is included correct?)
1. Now that same scenario WITH reduction - you code the reduction with the materials only? Application is included in the reduction procedure, right?
B. Pt comes into office, for the subsequent encounter of fracture after reduction and a splint has been applied previously, this visits they place waterproof cast. Do you code the office visit (with 25) and then the casting application and materials? Or no office visit if they did a reduction and splinting prior for global?
2. If they had a cast placed the first time and are back to have a replacement, you only code the office visit with the casting materials, correct?
Just trying to understand as my providers are all different and they place every single code on their forms, and I am trying to make a spreadsheet to help clear some of these up. Thank you all.