Fracture Care Billing Policy

Your insurance company requires that we bill our services to you using a coding system known as CPT (Current Procedural Terminology). The codes used to describe the services provided are found in the “surgery” section of the CPT codebook. This does not mean we are implying that you had an operation. This is merely the way the CPT book is organized for ease of use by both the insurance companies and physicians. According to the CPT guidelines, fracture care is billed as a “packaged” service.

INCLUDES

• Evaluation of the fracture and treatment plan

• The first cast or splint application

• 42-90 days of normal, uncomplicated, follow-up care

DOES NOT INCLUDE

• X-rays

• All casting supplies (including those used in the first cast or splint)

• Any replacement cast application and supplies

• The evaluation and management of any additional problems or injuries

• Treatment of complication

• Durable Medical Equipment

There will be a charge for services that are not included in the “package.” Please contact the Patient Account Representatives if you have any questions at 219-365-0220.