Orthopedic Coding Alert

Question: Encounter notes indicate that the provider applied a splint from a patient’s right hand up to the forearm. I was looking for a code for this service and saw two: one for a “static” splint and one for a “dynamic” splint. What is the difference between these two splints?

Wyoming Subscriber

Answer: The application codes you will choose from for this claim are 29125 (Application of short arm splint (forearm to hand); static) or 29126 (… dynamic). From there, you can also decide on a supply code for the splint. Choose from one of these codes for the splint supply, depending on encounter specifics:

• Q4021 (Cast supplies, short arm splint, adult (11 years +), plaster)
• Q4022 (Cast supplies, short arm splint, adult (11 years +), fiberglass)
• Q4023 (Cast supplies, short arm splint, pediatric (0-10 years), plaster)
• Q4024 (Cast supplies, short arm splint, pediatric (0-10 years), fiberglass)

Note: You might have a tough time getting paid for the splint supply; it’s entirely up to the carrier, and Medicare usually won’t reimburse for it. It cannot hurt to file the claim with the supplies you used, however — you might be reimbursed, and a patient’s medical record should always be as specific as possible to ensure maximally effective care.

In order to discover which type of splint the provider used, look for “static” or “dynamic” in the notes; also ask the provider if that is possible. If you cannot find what you need by looking for those key terms or querying the provider, you might be able to discern what type of splint the provider used based on the encounter notes.

A static splint has no moving parts. Providers apply them to support and protect the patient, but also to correct an injury. There is also a variation called a serial static splint, which allows lengthening of the tissue by placing soft tissue at the end of its range of motion (ROM).

Conversely, a dynamic splint does have moving parts. “A dynamic splint uses a tension spring that is integrated into a brace, usually via a mechanical hinge. The spring provides mild, long duration stress on the restricted joint to facilitate tissue remodeling. The tension spring can be adjusted for more or less tension to achieve range of motion goals with less pain,” according to vasportsmedicine.com. If you see anything in the notes that references this type of splint, it could lead you to 29126.