ED Coding and Reimbursement Alert

Question: Notes indicate that after a level-three ED evaluation and management (E/M) service, the provider applied a static finger splint to the patient’s left thumb. How should I report this encounter?

Connecticut Subscriber

Answer: On the claim, report:

• 29130 (Application of finger splint; static) for the finger splint application.
• Modifier FA (Left hand, thumb) appended to 29130 to indicate the anatomical area of the splint application.
• 99283 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused 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 99283 to show that a separate, significant E/M preceded the finger splint application.

No modifier 54? Since 29130 has a zero-day global period, you won’t need modifier 54 (Surgical care only). Typically, there is no follow-up visit for a finger splint or other zero-day global code.