Medical Professionals FAQs

Reimbursement Questions:

Are casting supplies bundled into the cast application codes?
No.  Per CPT guidelines in the Musculoskeletal System Section, “The services listed below include the application and removal of the first cast or traction device only.”  Also, as stated under the Medicine Guidelines Section, “Supplies and materials provided by the physician (eg, sterile trays/drugs), over and above those usually included with the procedure(s) rendered are reported separately.  List drugs, trays, supplies, and materials provided. Identify as 99070 or specific supply code.”

Are casting supplies reimbursable?
Yes.  Per the Federal Register July 17, 2000 and November 2, 2000 along with several Medicare Program Memos.  Offices are instructed to bill separately for supplies provided above and beyond the procedure.

What is the appropriate code to use when billing for AquaCast Cast Liner?
Currently carriers and CMS have recommended HCPCS A4590 or Q4050.

Do we need an Advance Beneficiary Notice?
Many carriers, including Medicare, have indicated that it is a good idea to get an Advance Beneficiary Notice (ABN) and/or waiver signed by the patient.

Can we collect payment up front from the patient for AquaCast Cast Liner?
Collecting payment up front from the patients can become an issue depending on your contracts.  If the patient’s insurance is not one that your office is contracted with, then you might be able to collect this money up front.  If your office is contracted with the patient’s insurance, you will need to find out what your contract states.  If you cannot locate this, we can provide you with a letter that can be sent to your contracted carriers for clarification.

How should we charge the patient for AquaCast Cast Liner?
Your office will have to develop an internal policy.  We have some clients who charge the patient a nominal fee and we have some that submit for reimbursement.

Can we bill separately for casting supplies?
Yes.  If you are applying cast padding and fiberglass that is purchased by your facility/office, you can bill the patient and/or insurance for those supplies.  This is outlined in the CPT Manual, Federal Register, Medicare Carriers Manual and by the American Academy of Orthopaedic Surgeons.

What are Medicare guidelines for billing and reimbursement for casting supplies?
You can find this information in the Federal Register of July 17, 2000 and November 1, 2000 as well as in the Medicare Carriers Manual sections 2050.1, 4821.B, and 15030.

Do we bill per roll or per cast for AquaCast Cast Liner?
Billing per roll or per cast is going to depend on the given carrier and your office’s practices.  Medicare has stated that the new Q codes are per cast.  If you do not know what your particular contracted carriers prefer, we have a form letter that can help you to obtain this information.

All AquaCast Liner products are not made with natural rubber latex.

Download Billing for Aquacast Liner