cast - Carolina Orthopaedic Surgery Associates

By Anthony Phillips,2014-02-08 15:45
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cast - Carolina Orthopaedic Surgery Associates


    “Thank goodness it’s only a fracture. I thought it might be broken.” People often think that a fracture is less severe

    than a broken bone, but fractures are broken bones. Bones are rigid, but when they are bent and the force is too great they will break. The physicians at Carolina Orthopaedic Surgery Associates, P.A. will discuss the type of fracture you have and the proper treatment of the fracture. Most fractures generally heal well. When the bone remains aligned, treatment normally only requires a sling, splint, or cast and follow up for 6 to 8 weeks. More serious fractures may require realignment of the bone in the office, a surgical procedure and in some cases hardware to keep the bone aligned until it is healed. As with all injuries there are risks associated with fractures. Even after the fracture has healed the patient may have some discomfort or pain in the joint. Also in later years arthritis may develop at the fracture site and in some instances a shortening of the bone may be noticed.


    ; Elevate your cast when swelling is present. Keeping your cast above your heart level will help reduce

    swelling and will help with pain control. Use pillows or other support which is comfortable to you.

    ; If the fracture is related to your hand/foot, move your toes and fingers frequently.

    ; If you have a cast keep it dry and as clean as possible.

    ; Do not ever stick objects into your cast even if your arm or leg “itches.” If you break the skin you may

    develop any infection that would not be noticed until the cast is removed or becomes painful.

    ; If your cast becomes wet, use a hair dryer on a low-cool setting to dry it. This may take some time. You

    should also note getting your cast wet may cause it to “smell.” This is normal and one reason why you

    should avoid getting it wet. Your insurance will not pay to have your cast changed due to this and should

    you desire to have your cast changed it will cost approximately $65.00.


    ; The area fracture site (outside the cast) becomes warm to touch or you notice any increased redness to the


    ; You develop a fever over 101 degrees

    ; You experience numbness or persistent tingling

    ; Your cast becomes too tight or too loose

    ; The edges of your cast become rough and cause problems with your skin

    ; You notice an unusual odor coming from within your cast and you have not gotten it wet or been out in the

    hot sun (sweating)


    MAKE SURE YOU CHECK WITH YOUR INSURANCE COMPANY regarding their policy on people

    driving with cast. Some policies will not cover the person driving if they have a cast. Also, be aware you are

    not to drive while taking narcotic pain medication.


    As we mentioned above, to help with initial swelling elevate the injured part of the body. This should be done

    by lying flat on your back so that the elevated part is higher than your heart. Do this whenever possible by

    using pillows, blankets or whatever is comfortable to you. Swelling may take 24-72 hours to reduce and may

    re-occur occasionally. Elevation will also help with pain control since the blood is not flowing directly to the

    injured area. When swelling is noted be up only when necessary.


    Your health care is important to us. We have physicians on call twenty-four (24) hours per day. If you have

    any emergency or problems relating to your treatment contact the office where you are being treated during

    normal hours. If an emergency arises after hours you may contact our physician on call at (803) 329-3130.


    Learn about fracture charges and billing questions on the reverse side.


Physician’s and other medical providers are required to bill according to insurance regulations which are established

    and monitored by the Insurance Commission and the government. This is often confusing to patients and understanding the guidelines that are to be followed will assist you in understanding the charges you have for services provided.

    CPT CODES: Physicians bill using CPT codes. These are numbers which have been assigned to describe different

     types of treatment that patients receive. Physicians are REQUIRED to bill according to the CPT guidelines which

     have been established. These codes are divided into different categories:

    o Evaluation & Management which covers routine office visits

    o Surgical Codes which include surgery, fractures and injections

    o Radiological Codes which include charges for x-rays, MRI’s, Cat Scans

    o Laboratory Codes which covers blood work which is ordered by your physician

    o Drug Codes Durable Medical Equipment which covers the medications you are provided and

    things such as braces, splints, crutches, ace bandages, etc.

    The fracture or surgery for which you have been treated falls under the surgical codes. This does not necessarily mean that surgery was performed but that the insurance guidelines require the physician to bill for this service as “global

    days.” Global days are days that have been assigned to a particular type of treatment where the physician must see the patient for the same injury without charging the patient additional charges for his services (Professional fees) as long as the treatment is related to the original injury and no complications have occurred. The number of global days for

    follow up varies by the type of surgery or fracture but is normally 90 days. Charges for other services are still billed. These may include:

    o Cast changes slings splints braces

    o Other supplies

    o X-rays

    o New injuries, repeat procedures due to complications

    o Treatment not related to the original fracture or surgery

    Each CPT code is assigned a charge amount. These are based on the medical expertise required and the average of the cost for treating the particular injury or service. In some instances a fracture or surgery patient may only require minimum treatment and does well, however another patient with the same injury may require extensive treatment. Since we must bill by CPT codes and we cannot vary the charge amounts an average is used for all CPT codes. These amounts are reviewed on a yearly basis and compared to other providers within a 200-mile radius. Our rates are based on the average cost to provide the service and average charges of other orthopaedic practices in the area.


    ; The initial office or emergency room visit (E&M Code) This charge covers the physician taking your

    medical history and reviewing information provided by you and other physicians. This is normally done

    before he comes into the room to begin treatment. These charges range from $90 - $200.

    ; Fracture Charge (Surgical Procedure) This charge covers the physician’s fee for treating the fracture.

    The physician may or may not have to align the fracture and may or may not have to take you to surgery.

    Remember each CPT code covers the type and extent of treatment being performed and the physician’s

    charges for follow up treatment for the fracture during the global period, 30-60-90 day as long as the

    treatment is continued care of the original injury. Fracture charges range from $250 - $950.

    ; X-rays if additional x-rays are taken in the office we will bill for the x-rays taken. If you bring x-rays

    from another facility the physician will review these and no charge will be made.

    ; Supplies Charges for things such as braces, slings, ace bandages, suture trays and other items are billed

    separately. Please note charges for cast changes due to patient request are not covered by your insurance.

    We hope this will answer any questions you may have. However, if you have any other questions, please call our office at (803) 329-3130 and we will be glad to assist you.

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