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CAST QUESTION

Vera Posted Mon 03rd of February, 2014 17:04:14 PM

2 part question:

When a patient gets a cast put on at the end of a surgical procedure at the hospital, - can I bill a 29405 with 58 modifier ? Someone told me I can only bill for the materials.

When a patient comes in for their first post operative appointment- a week after the surgery, can I bill for a cast then ? 29405 w/58 mod ? Is this included in the post operative global? Seems like the doctor should get paid for this ?

SuperCoder Answered Tue 04th of February, 2014 16:51:00 PM

The cast supplies are not included in code 29405; therefore, these items are reported separately using HCPCS code Q4038.

In both cases the answer is NO.

CPT® allows separate coding and charging of casts as a replacement procedure.Placement and removal of the initial cast is part of the surgical procedure that the patient had.

Assuming that the patient is seeing the same physician or a physician in the same physician group that placed the original cast, then you may not report its removal. Likewise, you may not separately report the removal of the replacement cast. The physician may not report the removal of the cast, because the removal by the same physician or a physician in the same physician group is included in the application code, whether initial or replacement. The removal of cast codes (29700-29715) may only be assigned when a different physician in a different physician group removes the cast. 

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