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. In your explanation of insurance benefits (EOB), your services may be paid as a surgical procedure with deductible and co-insurance applied. We always use the most appropriate code to describe your care. We are legally required to use this code when we bill this service. Be sure to check with your insurance provider and confirm your benefits.
CFOE participates with most insurances (Medicare, Humana, Blue Cross, Aetna, UHC, Cigna, UMR). Please contact your insurance company directly to confirm if CFOE does participate.
CFOE does accept monthly payments on balances, but currently does not offer “Auto Pay”. This feature along with being able to make payments on the website, should be options in the near future.