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ED Casting and Strapping for Facility Reporting

Kelly Posted Tue 22nd of October, 2019 16:49:05 PM
What CPT codes can the hospital report in the ED for Casting and Strapping when it is completed by a tech? What about when it is completed after reductions or manipulations by the physicians?
SuperCoder Answered Wed 23rd of October, 2019 03:07:47 AM

Hi,

If a patient is diagnosed with a fracture in the emergency department and the physician applies the cast, coders should report the code for the application of the cast. If the hospital staff applies the cast, the facility will report the same code. The facility should also charge for the supply, as appropriate.

If reductions or manipulations had been performed by the physician, CPT code for closed treatment of the fracture will be reported only, because cast application is integral to any definitive fracture treatment.

 

Pease check the below link for better understanding:

https://bok.ahima.org/doc?oid=91929#.Xa_3QegzbIU

 

Hope this helps!

 

Thanks

Kelly Posted Wed 23rd of October, 2019 11:30:57 AM
Thank you, but I am only interested in the facility/hospital charges to report. Can you please clarify for me? Are the following statements correct? If a patient seen in the ED is diagnosed with a fracture, and the physician applies the cast, the hospital only reports the supply code. If the physician performs reductions/manipulations in the ED, the hospital can report the CPT for treatment of the fracture, but not the supply code.
SuperCoder Answered Thu 24th of October, 2019 09:32:05 AM

Hi,

 

Yes, if a patient seen in the ED is diagnosed with a fracture, and the physician applies the cast, the hospital only reports the supply code.

 

As per NCCI edits,  If a physician treats a fracture, dislocation, or injury with a cast, splint, or strap as an initial service without any other definitive procedure or treatment and only expects to perform the initial care, the physician may report an evaluation and management (E&M) service, a casting/splinting/ strapping CPT code, and a cast/splint/strap supply code (Q4001-Q4051).

 

On the other hand, If the closed reduction had been performed in the emergency department, the facility would only assign codes for the treatment (for physician) and the supply (for hospital), if applicable, but not for the application of the cast.

 

Thanks

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