QUEST Integration – Casts and Strappings

Original Effective Date:

04/01/1999

Current Effective Date:

01/01/2015

The initial cast application and removal of the cast are included in the global surgical fee when surgical procedures are involved. Replacement of the initial cast is payable as a separate item.

For non-surgical cases (e.g., cast/strapping of sprained ankle or knee), the initial cast application and a visit (office, hospital emergency room) are payable.

Fiberglass casting is covered when it is necessary and not as a convenience item. For example, active children unable to take proper care of a plaster cast, or adults whose job requirements or other situations make plaster inappropriate may receive a fiberglass cast.

Claims Filing Information

The application of the cast is billed using the appropriate CPT procedure code. Cast supplies must be reported using the applicable CMS alphanumeric code or CPT code 99070. If code 99070 is used, please include a complete description of the cast and supplies or the claim will be denied.

When fiberglass casts are used, claims must provide justification for its use and include an itemization of the supplies used (e.g. size and number of rolls used) with the applicable CMS or CPT code.

Revision History