# Office visit cast application and injection



## ortho1991 (Apr 21, 2010)

Hi All

We billed 99213/25 office visit
             29125/58 thumb spica splint
             20550 injection
             J1020 corticosteriod.
             73130 X-rays.
All but the 29125 splint was paid. MA. Medicare states 29125 and 20550 are included. I just don't understand how they are. Do we need a modifier on the 20550.  I checked our local Blue Shield carrier, and they allow everthing.

This is happening to everyone??  Any advice or feedback will be apprecated

Thank you.


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## montie99 (Apr 22, 2010)

Are you in a post op period? Was the injection for the same problem?


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## ortho1991 (Apr 27, 2010)

No we are not in post-op period. Here is a short version of the office note.

Pt seen in office today for RT thumb and wrist discomfort. She states since Dec. she has had pain along the base of the thumb and up into the forearm area.

Exam of these wrist and thumb was done.

Since her discomfort has been ongong since Dec. My recommendation would be to give her a trial of corticosteroid injection.  Pt was injected into the tendon sheath.  We will aslo get her in thumb spica splint today for support.

I hope this helps.


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## montie99 (Apr 27, 2010)

Cci edits do show they are bundled. -58 is a post op modifier and should not be used. I would have done 99213 -25 and billed for the application or the injection. You should also be charging for for the plaster or fiberglass.


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## halebill (Apr 29, 2010)

I agree with response from montie99. Always pay attention to your CCI edits. Just because a carrier may pay items which are bundled, doesn't mean you will keep that payment.


Bill Hale, CPC


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## ortho1991 (Apr 30, 2010)

Thanks for all you help. Cathy


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