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Click here for more sample CPC practice exam questions and answers with full rationale

Cast Complication

Hi,

I have doubt regarding cast complication when a patient arrives hospital due to cast discomfort that created pain/ swelling/ in case too tight/loose after 2-3 days of closed reduction of radius fracture, what encounter do we use for the visit- initial or subsequent?
Can we apply the below concept? . please help

For complication codes, active treatment refers to treatment for thecondition described by the code, even though it may be related to an
earlier precipitating problem. For example, code T84.50XA, Infection and inflammatory reaction due to unspecified internal joint prosthesis,
initial encounter, is used when active treatment is provided for the infection, even though the condition relates to the prosthetic device,
implant or graft that was placed at a previous encounter.7th character “A”, initial encounter is used for each encounter where the
patient is receiving active treatment for the condition.

Kindly any one please convey your ideas. Thank you.

Regards,
Menaka.

Medical Billing and Coding Forum

Cast Complication

Hi,
I have doubt regarding cast complication when a patient arrives hospital due to cast discomfort that created pain/ swelling/ in case too tight/loose after 2-3 days of closed reduction of radius fracture, what encounter do we use for the visit- initial or subsequent?
Can we apply the below concept? . please help

For complication codes, active treatment refers to treatment for thecondition described by the code, even though it may be related to an
earlier precipitating problem. For example, code T84.50XA, Infection and inflammatory reaction due to unspecified internal joint prosthesis,
initial encounter, is used when active treatment is provided for the infection, even though the condition relates to the prosthetic device,
implant or graft that was placed at a previous encounter.7th character “A”, initial encounter is used for each encounter where the
patient is receiving active treatment for the condition.

Thanks
Menaka.

Medical Billing and Coding Forum

Smart Cast

Our podiatrist is looking to offer Smart Casting for patients who present to have foot orthotics molded. Currently, this is a manual process for him. With Smart Cast, it is a digital 3D image that allows a third party to receive the images and create the casting without the patient waiting for the molding to dry on their feet.

Does anyone else use this service? The company is called Smart Cast and is orthotic specific. If so, what CPT or HCPCS codes do you use? I am not finding anything in my research, and many that is because it is a new technology?

Thank you,

Ann Lilly, CPC, CEMC, COBGC
Coding Manager
Porter Medical Center
Middlebury, VT 05753

Medical Billing and Coding Forum

Short Leg Cast Removal

Hi All,

I have a provider who removed a short leg cast for a patient. A different provider originally placed the short leg cast. The only code I can find is 29705, but this doesn’t seem appropriate to me because the description is for removal of a full arm or full leg cast.

Would anyone be able to assist?

Thank you.

Medical Billing and Coding Forum

Removal of Kyphoplasty cement cast

Good morning, all. I hope you can assist me with this.

My physician did a kyphoplasty on 08/25/17. On 08/30/17, she returned to the office complaining of increased left sided back pain. An x-ray revealed cement casting. On 09/06/17, she returned to the OR to have the cement casting removed. Below is part of the report:
After identifying the left T11 Kyphoplasty cement cast fluoroscopically, the skin was sterilely prepped and draped in the usual fashion using betadine times three. The skin and subcutaneous tissues were anesthetized with 1% Lidocaine using a 25 gauge 1.5 inch needle and a 25 gauge 3.5 inch spinal needle for deeper tissues. Then the 25 gauge 3.5 inch spinal needle was used to inject 0.5% bupivicaine with epinephrine for further local anesthetic control and hemostasis. An 11-blade scalpel was used to make a 1-2 cm incision overlying the left T11 Kyphoplasty cement cast. Soft tissue dissection was then carried out along the left T11 Kyphoplasty cement cast down to where the cast enters the left T11 pedicle. A needle driver was then used to grasp the cement cast at the junction where the cast enters the left T11 pedicle. The cast was then severed from the left T11 pedicle juncture and removed from the body without difficulty. The incision site was then copiously irrigated with saline mixed with bacitracin. The deep soft tissues were closed using 2.0 vicryl sutures. The skin was closed using a skin stapler.

How do I bill for this? I looked at the "foreign body removal" codes, but none of those fit. Any assistance will be greatly appreciated.

Medical Billing and Coding Forum