Wiki New to Ortho Coding - HELP

mullman

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I am new to ortho coding. Our hospital used to do all Ortho charges but now we are doing them in clinic billing dept. We've had really no guidance. One thing I am wondering is if you can bill for a visit (initial or subsequent) and casting/splinting.

I.e.: Patient presents for a new problem, found to have a fracture of hand. There is no surgical procedure required however a cast is placed at this visit.

I am billing the E&M AND the casting code. I am getting some coworkers who don't agree with this. Reading the CPT book guidelines it appears I can bill them both. I don't see that casting or splinting is inclusive to the E&M.

Who is correct? Any help is appreciated.

Also, does anybody have a good reference to read for Ortho billing?
 
Yes

You can bill for the casting in addition to the E/M code if you are not charging fracture care. If you charge fracture care, then the 1st casting/splinting is included.

KZA and AAOS have good Orthopedic webinars, workshops, etc.
 
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