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Updated policy on cast and splint applications and supplies

September 21, 2017

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AmeriHealth has updated its billing requirements on cast and splint applications and associated supplies that are provided in an office setting. Claim Payment Policy #00.10.15c: Cast and Splint Applications and Associated Supplies Provided in the Office Setting is currently posted as a Notification and will go into effect December 1, 2017.

The following HCPCS codes have been added to this, effective December 1, 2017:

  • E0117: Crutch, underarm, articulating, spring assisted, each
  • E0118: Crutch substitute, lower leg platform, with or without wheels, each

The following HCPCS codes are no longer eligible for reimbursement, effective December 1, 2017:

  • A4570: Splint
  • A4580: Cast supplies (e.g., plaster)
  • A4590: Special casting material (e.g., fiberglass)

For more information

A comprehensive list of eligible codes for cast and splint applications and associated supplies that are provided in an office setting can be found in Attachment A of the policy listed above.

To view the Notification for this policy, visit our Medical Policy Portal. Select Accept and Go to Medical Policy Online, and then select Commercial under Active Notifications.

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