tci Part B Insider - 2005 Issue 5

Reimbursement: Multiple Reductions, One Cast: How Many Codes Can You Bill?

Provide justification if you bill more than one codeThis little piggy has a stress fracture, and this little piggy has a complex fracture. The physician performs a closed reduction on both toes, and only applies a single cast to both metatarsal fractures. Can you bill more than one global code?The answer is a judgment call, say coding experts. How many codes you can bill depends on whether the physician performed a non-manipulation (CPT 28470 ) or manipulation (28475) reduction. Another consideration: How likely the physician believes each fracture is to develop separate complications during the 90-day global period...

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