What is "fracture care"? Why am I being charged for a surgical procedure when I never had surgery?
Your Insurance Company requires that we bill our services to you using a coding system known
as CPT or Current Procedural Terminology. The codes used to describe the services we
performed for you 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 insurance companies and physicians.
According to CPT guidelines, fracture care is billed as a "package" service. This means that
at the time of initial care, a bill is generated that includes:
- Evaluation of the fracture.
- The first cast or splint application
- 90 days of normal, uncomplicated follow-up care.
The items/treatment that are not included in the package and require a separate charge are:
- X-rays
- All casting supplies, including those used in the first cast or splint application
- Any replacement cast or splint application
- The evaluation and management of any additional, separate or new problems or injuries
- The treatment of complications
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