Query: Coding for the Bivalving of a Cast
Is there a CPT code I can use when a physician bivalves an existing cast that he/she previously applied? I considered using CPT 29700 (removal or bivalving; gauntlet, boot or body cast), but this code should only be used if the cast was applied by another physician.
Tina Houser, Houston, TX
Response: You are correct that CPT 29700 can only be used if the physician who is bivalving the cast did not apply the cast.
If the cast was applied following a procedure that has a global period (such as bone surgery or fracture care), and you are still within the global period, then you also cannot bill for an evaluation and management service. If, however, the doctor did not bill a treatment CPT with a global period (e.g., the patient had a fracture, but rather than billing the CPT for closed reduction of a fracture, he/she billed an E/M service + cast application), then an E/M service may possibly be billed, assuming there was a distinct evaluation and management performed and documented.
Mark Schilansky, DPM, Catskill, NY
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