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Updated policies on cast and splint applications and supplies

September 21, 2017

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Independence has updated its billing requirements on cast and splint applications and associated supplies that are provided in an office setting. The following policies are currently posted as Notifications and will go into effect December 1, 2017:

  • Commercial: #00.10.15c: Cast and Splint Applications and Associated Supplies Provided in the Office Setting
  • Medicare Advantage: #MA00.012b: Cast and Splint Applications and Associated Supplies Provided in the Office Setting

The following HCPCS codes have been added to these policies, 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 policies listed above.

To view the Notifications for these policies, visit our Medical Policy Portal. Select Accept and Go to Medical Policy Online, and then select Commercial or Medicare Advantage under Active Notifications.

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