08/29/2017

Proper Billing for Supplies During a BK Fiberglass Cast

I am wondering how to appropriately bill for the supplies during a BK Fiberglass cast. A4590? or Q4038? Also, can you bill for each roll or is it bundled into the one code? Thank you in advance

The HCPCS code reported depends on the insurance that the cast is being billed to:

• Medicare and Medicare Advantage plans do not recognize the A codes, therefore, Q4038 would need to be billed.
• Medicaid does not recognize either code, so it would be a non-covered service for the specialty. Medicaid Managed Care plans may or may not cover the supplies depending on their policy for casting services.
• Commercial plans may cover either code, depending on the patient’s benefit plan. We tend to use A4590 and charge $75 fee for one unit.
• Some will deny either code as being inclusive to the cast application, while others may reimburse one to both codes in addition to the BK cast application. 29799 LT $75 and 29799 RT $75 ,billed on separate lines.

Whichever code is used, only one unit of service may be billed for the DOS on a claim for the actual cast material regardless of how many rolls of material were used on the DOS.