Getting Reimbursed for Applying Casts and Splints
Published on Wed Dec 01, 1999
Casts, splints and straps are immobilization devices applied to protect injured bones and soft tissue and to reduce pain, spasm, and swelling following a surgery. Application of these devices is often part of a global surgery. In that case, casting is part of the global charge and cannot be billed separately.
There are many variations on casting, however. Being alert to them means claiming all the reimbursement to which a provider is entitled.
Correct Coding for Splinting
Physicians often forget to bill for the splint when they apply one to a patients sprained finger during an office visit.
The strapping codes are rarely used in cases such as a finger sprain, says Dari Bonner, CPC, CPC-H, CCS-P, the president of Xact Coding & Reimbursement and a corporate compliance coding/reimbursement specialist for a large health system in Florida.
Bonner says, Physicians usually will bill the evaluation and management (E/M), CPT 99201 - 99220 . But they apply a splint and rarely bill for it because it is often
not reimbursed.
But coding for the splint is still a good idea. Bonner says the appropriate way to code the application of a finger splint to a sprain is to use 29130 (application finger splint, static) or 29131 (application finger splint, dynamic), where static and dynamic refer to whether the appendage can be moved while in the splint.
Coders are less likely to overlook the opportunity to claim splints for arms and legs even though the first cluster of codes in the 29000 series is for splint applications.
Note: Casting and strapping codes are in the 29000-29590 range.
Splint applications are listed for long arm (29105, application of long arm splint [shoulder to hand]) and short arm (29125, application of short arm splint [forearm to hand]; static) and (29126, application of short arm splint [forearm to hand]; dynamic), says Bonner. Long leg and short leg splint applications are subdivided on the same principle.
Bonner cautions that the 29000 series codes are only to be used when the cast application stands alone as a procedure. She says to use the series codes for the initial application when no treatment other than the application is provided.
In other words, says Bonner, no manipulation of a fracture or other surgical treatment [was initially required]. When other procedures [such as surgery] are performed, the initial application of casting, strapping or splinting is inclusive of the procedure performed and may not be billed with the initial treatment.
An example of a global CPT for surgery and casting is 27532 (closed treatment of tibial fracture, proximal [plateau]; with or without manipulation, with skeletal traction).
Replacements CountMost of the Time
There is another instance when billing for [...]
