Cast Reapplication Conundrum

Question:

The patient initially presented with a wrist sprain and was treated with a short arm splint. Two days later, the patient returned due to the splint becoming wet or loose, and the physician removed and reapplied a new short arm splint. In this scenario, can the splint procedure be separately reported, or is it included in the E&M service?

Answer:

The reapplication can be billed separately using the appropriate application code.  It is not automatically included in the EM code. 

The CPT guidelines specifically states that while the initial application of a cast or splint is bundled into the fracture treatment, reapplications are reported separately using the 29000-29799 series.  

To support the EM, the note must show that the doctor's medical decision making went beyond just the mechanics of the splint replacement.  Most cast and splint application codes have a 0 day global period, because there is no surgical package associated with the wrist sprain, the reapplication on a subsequent day is billable.

*This response is based on the best information available as of 10/01/26.