Health Information Management

Clarifying casting and strapping

APCs Insider, February 25, 2005

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Clarifying casting and strapping

Question: Coders at our facility continue to struggle with the definitions of strapping and casting. Could you provide further explanation? How do we code for the application of a soft boot or una boot, arm sling, or knee immobilizer?

Answer: Here are definitions of splinting, strapping, and casting that may prove helpful:

· Casting is the immobilization of an affected joint.  It is a labor-intensive process, requires training, and is essentially a fabrication of a specialized, customized device that is molded to a specific patient.

· Strapping is customized reinforcement and support for ligament structures through restriction of movement for increased stabilization. It requires specialized knowledge not only of the anatomical structures being strapped, but also of the method of applying the strap for the best support of these structures.

Note:  Casting/strapping procedures are incidental to fracture or dislocation treatment (closed or open reduction of a fracture). Do not separately report casting and strapping procedures with fracture/dislocation treatment codes.

· Splinting is the application of an appliance made of wood, metal, plastic, or plaster. These appliances are used for fixation, union, or protection of an injured part of the body.

Techniques for post-op boot, sling, ace bandage, and air cast application typically do not rise to the level of skill and knowledge required of casting, strapping, or splinting.

Note: Applying a sling is a first-aid technique, as is a normal Ace bandage application. Therefore, do not code the application of the following materials: Post-op shoe, sling, Ace bandage, or air cast. These are considered supplies, so report them as supply items, not as casting or strapping services.



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