ED Coding and Reimbursement Alert

Question: The ED physician performed an evaluation and management (E/M) service for a patient who had a sprained left ankle and wrist. Then, they applied short splints to the patient’s ankle and wrist using molded non-off-the-shelf materials. Can we code separately for the splint application, or is that part of the E/M service?Maine Subscriber

Answer: You can code separately for the splint applications. On the claim, report:

• 29515 (Application of short leg splint (calf to foot)) for the short leg splint.
• Modifier LT (Left side) appended to 29515 to indicate laterality.
• S93.02XA (Subluxation of left ankle joint, initial encounter) appended to 29515 to represent the patient’s ankle sprain.
• 29125 (Application of short arm splint (forearm to hand); static) for the short arm splint.
• Modifier LT (Left side) appended to 29125 to indicate laterality.
• S63.002A (Unspecified subluxation of left wrist and hand, initial encounter) appended to 29125 to represent the patient’s wrist sprain.
• 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity...) for the E/M.
• Modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) appended to 99284 to show that it was a significant, separately identifiable service from the splint applications.
• S93.02XA and S63.002A appended to 99284 to represent the patient’s ankle and wrist sprains.