Here are some highlights from the Nov. 2012 Q&A Webinr transcript:
Laureen: I took this right from the guidelines. That’s how I like to teach versus, I view textbooks and exercises as important. But I like to teach from the manuals because that’s what you’re taking into the board exam. This is where you should be making your notes to jog your memory of you know, certain key principles.
For fracture care, if you’re doing the one that has a 90 day global period, part of that is often times going to be initial casting and strapping. That’s bundled in. So the global package includes that pre-op thing. In the case of fracture care, that doesn’t really apply. The service itself or the surgery itself and then the follow up period which is for major surgeries, is about 90 days. Some are 0 days, some are 10 days and some of your private payers have even longer than 90 days, but your average is 90 days.
So picture the patient coming in and the doctor doing something to manipulate the fracture, put it back in place or you know, do some traction or whatever. He or she is going to code that CPT code that includes the initial casting and strapping.
Where we go wrong as coders is we feel that every subsequent cast because as you know, people normally need at least one cast change especially if it’s for a kid before they’re outside of that global period or before the cast comes off for good. Because that is not predictable you know, if AMA can package it, they will. But because they cannot predict how many times someone’s going to need a cast change, that is allowed to be billed separately.
And that’s what this paragraph is saying. [Ed. Note: In the webinar/ replay video, you can see where Laureen is looking at the guidelines.] "The listed procedures for the cast and strapping apply when the cast application or strapping is a replacement procedure, not initial. Used during or after the period of follow up care or when the cast application or strapping is an initial service performed without restorative treatment. "
So that second part means there is no doctor that’s billing the global code, the code that has a global period. All they’re doing is applying a cast or strapping. That is the treatment, that’s it. The end. Then they’re allowed to obviously code that on its own.
Okay, so the mistake that a lot of new coders make is maybe they’re coming in a month later, 6 weeks later and having their cast changed. And they feel that that’s bundled into the global period and they can’t bill for it. According to these guidelines, that’s not true. You can go ahead and bill for that.
Laureen continued with some more tips which are available on the
replay video.
