Your insurance provider requires that we bill our services using a coding system called CPT (Current Procedural Terminology) when treating you or your dependent for a fracture. These codes can be found in the “surgery” section of the CPT codebook. This does not mean that you had surgery. It’s simply how the CPT codebook is organized for physicians and insurance providers.
CPT guidelines state that we must bill fracture care as a “packaged” service. At the time of initial care, we will generate a bill that includes:
1. Your fracture treatment
2. Your first cast or splint application
3. 90 days of normal, uncomplicated follow-up care
NOT INCLUDED* in the package:
2. Casting supplies (including those in first cast application)
3. Replacement cast application
4. Evaluation and management of additional problems or injuries
5. Treatment of complications
*These services will be charged separately.
Your insurance provider may cover fracture care differently than office visits. Be sure to check with your insurance provider and confirm your benefits.
If you have any questions about our fracture care fees, please call our billing office at 304-263-5129.
Our billing office (Surgical Management Solutions) is located in Suite 101 in the same building as us. They manage all of our billing services as well as the billing for Tristate Surgical Center.
Phone number: 304-263-1637
Monday-Thursday – 8:00 am – 4:30 pm
Friday – 8:00 am – 2:00 pm