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Fracture Care Billing Explanation

CPT Guidelines

Insurance companies require we bill our services using a coding system known as Current Procedural Terminology (CPT).  These codes, located in the “surgery” section of the CPT codebook, identify the exact fracture and the care rendered.   The term “surgery” does not imply an operation was performed; this is merely the format in which CPT is organized for ease of use by both the insurance companies and physicians.

According to CPT guidelines, fracture care is billed as a “package” or “global” service.

This means that at the time of initial care, a charge is generated that INCLUDES:

  • Evaluation of the fracture
  • The APPLICATION of the first cast or splint.  (There will be a separate charge for supplies)
  • 90 days of normal, uncomplicated, follow up care

Items NOT INCLUDED in the package or global service charge:

  • X-rays
  • All casting or splinting  supplies or durable medical equipment
  • Any replacement cast, splint or supply application
  • The evaluation and management of any additional problems or injuries
  • The treatment of complications

Items not included will be billed as separate charges.

Billing Office Hours
Monday-Friday 9AM to 12PM and 1PM to 4PM
Phone 503.905.4110

Primary Physician Referral
We accept referrals from all primary care physicians.

Managed Care Plans
We are a participating provider with most major
health care and workers' compensation plans.

To make an appointment at either office, please call 503-214-1101, or request an appointment, online.

"Our physicians and staff strive to provide
the highest quality of orthopedic care to the
satisfaction of our patients"

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