Fracture Care Billing Policy


Fracture Care Information

Your insurance company requires that we bill our services to you using a coding system known as CPT (Current Procedural Terminology). The codes used to describe the services provided are found in the "surgery" section of the CPT codebook. This does not mean we are implying that you had an operation. This is merely the way the CPT book is organized for ease of use by both the insurance companies and physicians.

According to the CPT guidelines, fracture care is billed as a "packaged" service. This means that at the time of the initial care, a bill is generated that includes:

  • Evaluation of the fracture and treatment plan
  • The first cast or splint application
  • 42-90 days of normal, uncomplicated, follow up care


Services that are not included in the package are:

  • X-rays
  • All casting supplies (including those used in the first cast or splint)
  • Any replacement cast application and supplies
  • The evaluation and management of any additional problems or injuries
  • Treatment of complication
  • Durable Medical Equipment


There will be a charge for services that are not included in the "package." Please contact the Business Office if you have any questions at 816-532-2090