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Fracture Care & Casting:
xray fractureOur clinical staff is well trained to make sure that your fracture is well protected in a cast applied at our facility . . . and yes, you can choose from a  variety of popular colors!!

 

About Fracture Care

Your insurance company requires that we bill our services to you using a code system known as CPT (Current Procedural Terminology). The codes used to describe the service we provided for you are found in the “surgery” section of the CPT codebook. This does not mean we are implying that you had an operation, or even a specific invasive or non-invasive procedure, such as fracture reduction. 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. This means that at the time of initial evaluation and beginning your care with us, a bill is generated that includes:

1.       Evaluation of the fracture, whether or not a repair or manipulation is required
2.       Application of the first cast or splint
3.        90 days of normal, uncomplicated, follow-up care.
The things that are not included in the package are:
1.       X-rays
2.       All castings supplies (including those used in the first cast or splint)
3.       Any replacement cast application
4.       The evaluation and management of any additional problems or injuries not related to this fracture
5.       The treatment of complications (There would be a separate charge of these).
If you have an HAS or any high deductible insurance plan, you will be billed once the insurance carrier (NOT Orthopaedic Associates of Wausau) determines what your balance is for all of the above. Most insurance carriers will send you what they send to us, an Explanation of Benefits telling you what your financial responsibility is for the care according to their discounted fee schedule.
We must use fracture care codes in compliance with AMA guidelines. Our participation with Medicare and contracts with other insurers allow us to pass their discounts along to you. We cannot offer additional discounts or change codes as it is non-compliant with these contracts.