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Jewett Fracture Care: Treating Sprains, Strains and Broken Bones

All insurance companies require that our services are billed using a coding system known as CPT (Current Procedural Terminology). The codes used to describe the services performed are found in the surgery section of the CPT code book. This does not mean you had an operation; it’s simply the category that the healthcare industry uses for fracture care billing. Your insurance explanation of benefits (EOB) may list our services as surgery. This is appropriate based on medical billing guideline standards. According to CPT guidelines, fracture care is billed as a package or global service. Meaning, at the time of initial care, a bill is generated including:

  • Treatment of the fracture.
  • First cast or splint application (this does not include supplies nor any subsequent casts).
  • 90 days of normal, uncomplicated, follow-up care. There are items that are not included in the packaged service.

These services will be billed in addition to the fracture care code:

  • Initial evaluation by Jewett Orthopaedic Clinic Physician or Physician’s Assistant
  • X-rays
  • Casting supplies and/or support/braces applied

Water proof casting materials may not be covered by your insurance. Many health plans considered the application of this material a patient convenience rather than medically necessary. If your insurance denies this coverage, you will be responsible for paying this portion of the bill. If you have any questions regarding your bill, feel free to contact our billing customer service line: 407.599.1685. Monday through Friday, 8:00am to 5:00pm. If you have any questions about your medical care, please contact the physician’s office where treatment was received.

For Billing-Related Questions

Please call 407.599.1685

Caring For Your Fracture

What is a Fracture?

A fracture is any break in the surface of the bone. Sprains can sometimes include a fracture. While some fractures are treated with casts, others only require a brace, sling or other support. You may have been seen in the emergency room or by your family physician and referred to an orthopaedic physician. The Jewett Orthopaedic Clinic team will determine the best treatment of the fracture and perform the follow-up care.

Follow-up Treatment

It is important that you continue treatment after the fracture has been diagnosed. Average healing time for fractures is approximately 3 months. Consistent followup will minimize the potential for longterm issues with improperly healed fractures. Your physician will discuss the frequency of those check-ups. (There will not be a charge for the physician portion on follow-up visits. See reverse side for billing details for fracture care.)

Cast Care Instructions

A cast has been applied to immobilize a fracture, ligament/tendon injury or joint dislocation to promote healing and provide you with the best medical outcome. Please take a few moments to read the following information regarding the care of your cast.

Reducing Swelling

It is important to elevate a casted extremity often. Elevation above your heart is best. Use pillows or cushions under the extremity for comfort when reclining or at night when sleeping. Keeping the knee slightly bent when reclining will help limit back pain. If you have been issued a sling you may hold your arm below chest level. To reduce swelling, apply a cold pack or bag of frozen peas directly on top of the cast. If ice is used, place it in two ziplock freezer bags to prevent leakage. Additionally, to help decrease swelling and prevent stiffness, you should wiggle your toes (for leg casts) or make a fist (for arm casts) several times per day. If you have an arm cast, it is important to move your shoulder.

Bearing Weight

Those with a leg cast should not bear any weight without approval from your physician. When allowed, you should start out using crutches and weight bear to your comfort level or to the extent

Showering and Itching

It is NOT necessary to wear the “shoe” when bathing, showering or sleeping. You will need to take precautions not to get your cast wet when bathing or showering. It is important not to put anything inside your cast. This can cause bleeding, pressure sores or an infection. If you experience itching, tap on the cast or use a hair dryer on the cool setting. Over the counter Benadryl can also be taken. If other medications are being taken or you have medicine allergies, check with a pharmacist before taking Benadryl with the other medication.

Unless the cast has waterproof cast padding, keep it dry. Normal casting material, when wet, will cause a breakdown of the material, affect the skin and increase itching. If you have an incision and your cast becomes wet, you will need to see your physician or physician assistant to prevent your incision from becoming infected. If you DO NOT have an incision, a hair dryer may be used to dry the cast material. The process takes a minimum of an hour. If you are unable to get the cast dry, call the Jewett Orthopaedic Clinic for possible cast replacement.

You should NOT attempt to remove or alter your cast! Our physician offices have specialized tools to remove casts safely.

When to call Jewett Orthopaedic Clinic

Should you experience any of the following:

  • Extreme pain not relieved by elevation and pain medication.
  • Numbness or tingling not relieved by elevation.
  • Tightness not relived by elevation.
  • Swollen, cool or discolored fingers or toes not relieved by elevation.
  • It is normal to have bruising.
  • Broken or wet cast.

Please call 407.647.2287

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