Casting supply codes

March 1st, 2009 - Codapedia Editor
Categories:   Coding   Relative Value Units (RVUs/RBRVS)  
0 Votes - Sign in to vote or comment.

HCPCS codes include temporary codes developed by CMS.  Sometimes, the temporary codes stick around for a while.

There are HCPCS codes for the provision of cast supplies to Medicare patients.  A physician office may always be paid for the cost of the casting materials, whether billing global fracture care of E/M services.  If the group is charging for fracture care, using the Ortho fracture care codes, then do not bill for the application of the cast.

The cast supply codes are Q codes, ranging from G4001 through G4051.  These codes are found in the HCPCS book.  They are divided by the location of the injury (arm, head, leg, ankle), the type of material used (fiberglass, plaster) and the age of the patient (child or adult).  Physician offices who apply casts should keep an updated list of these codes available to them.

Medicare and many third party insurers do not pay separately for most supplies used in treating the patient in the physician office. This is because the cost of the supply is factored into the practice expense Relative Value Unit of the code, and so CMS has already paid you for it.  Casting supplies is one set of supply that is reimbursed separately. Be sure to bill for it.

###

Questions, comments?

If you have questions or comments about this article please contact us.  Comments that provide additional related information may be added here by our Editors.


Latest articles:  (any category)

CMS says Codes are on the Move!
December 9th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
Have you noticed your LCDs are missing something? CMS is moving codes out of LCDs and into Billing and Coding Articles. MACs began moving ICD-10-CM, CPT/HCPCS, Bill Type, and Revenue codes in January 2019, and will continue through January 2020. Therefore, if there is an LCD with its codes removed, you will find ...
Preview the PDGM Calculator for Home Health Today
December 4th, 2019 - Wyn Staheli, Director of Research
Until February 1, 2020, you can preview Find-A-Code's Patient-Driven Groupings Model (PDGM) home health payment calculator by going to https://www.findacode.com/tools/home-health/ .
Hypertension ICD-10-CM Code Reporting Table
November 25th, 2019 - Wyn Staheli, Director of Research
In ICD-10-CM, hypertension code options do not distinguish between malignant and benign or between controlled and uncontrolled. What is important for code selection is knowing if the hypertension is caused by or related to another condition. The following table shows some of these options.
New Medicare Home Health Care Payment Grouper — Are You Ready?
November 25th, 2019 - Wyn Staheli, Director of Research
In 2020, Medicare will begin using a new Patient-Driven Groupings Model (PDGM) for calculating Medicare payment for home health care services. This is probably the biggest change to affect home health care since 2000.
VA: How UCR Charges are Determined
November 20th, 2019 - Chris Woolstenhulme, QCC, CMCS, CPC, CMRS
How does the VA determine charges billed to third party payers for Veterans with private health insurance? According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...
Medical Insurance Coverage for TMJ Disorders (TMD)
November 19th, 2019 - Christine Taxin
It is agreed that TMJ disorders should be covered by insurance. There are often questions whether it is covered by medical insurance or dental insurance and where the line is that separates coverage.Medical Insurance typically is the primary insurance for TMJ disorders. The reason is that joints are found anywhere ...
Changes to Portable X-Ray Requirements
November 19th, 2019 - Wyn Staheli, Director of Research
On September 30, 2019, CMS published a final rule which made changes to portable x-ray services requirements as found in the law.



About Codapedia by innoviHealth Contact Us Terms of Use Privacy Policy Advertise with Us

innoviHealth - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain) - Fax (801) 770-4428

Copyright © 2000-2019 innoviHealth Systems, Inc. - CPT® copyright 2018 American Medical Association