Your insurance company requires that we bill our services using a coding system known as CPT (Current Procedural Terminology). The codes used to describe these services are found in the “surgery” section of the CPT codebook. However, this does not necessarily mean or imply that we performed a surgical procedure. This is merely the way the CPT book is organized for ease of use by both the insurance companies and physicians.

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

1.      Evaluation of fracture

2.      The first cast or splint application

3.      90 days of normal, uncomplicated follow-up care

The things that are NOT INCLUDED in package are:

1.      X-rays

2.      All casting supplies (including those used in first cast or splint)

3.      Any replacement cast applications

4.      The evaluation and management of any additional problems or injuries

5.      The treatment of complications

6.      Any and ALL DME’s

There will be a separate charge for the above items.

If you have any questions, please do not hesitate to contact the billing dept at (973)-538-7700 Monday through Friday between 9:00 am and 5:00 pm.