Question

2. Application or removal of a cast or splint can be billed separately in some situations but not in others. In which situations is separate billing appropriate? Why do some situations dictate separate billing but others treat cast application as an included procedure?

Answer 1

If applied as a part of a fracture repair, you do not code application service separately. Application and removal a bundled into the fracture repair codes. If subsequent cast, strapping, or splint is applied within follow-up period, you can bill by coding application as well as materials and adding modifier -58. Separate office visits can be billed only if the patient is provided some other separate and significant service while not in the global period in addition to application of the item. Add modifier -25 for this

When the physician applies initial cast, strapping, or splint for stabilization prior to definitive treatment by another provider, applies subsequent cast, strapping or splint, treats sprain, and does not expect o provide any other type of restorative treatment.