Orthopedic Coding Alert

Question: What is the difference between splinting and strapping, and how can we determine when to report each one?


Montana Subscriber


Answer: Although the rules are pretty clear when the physician applies a cast to a patient, knowing when to report splinting or strapping is murky territory at best.

Codes for both services are in the 29000-29799 code set (Application of casts and strapping), but you-ll have to know what constitutes splinting and strapping before you can code either procedure correctly.

Clinical conventions say strapping involves layers of tape, web roll, and possibly an Ace bandage. The joint is well-supported by strapping, but with these non-rigid materials, the patient retains some range of motion.

Splinting has evolved over the years as more efficient products have become available. Previously, splints were predominantly plaster, then fiberglass. Now, there are a whole host of pre-made -off-the-shelf- plastic products. These newer generation of splints and splinting materials are more rigid. Further, they provide greater support with less freedom and a smaller range of motion.

Remember: Your physician must apply the splint or strap, or you cannot report the 29000-29799 codes to Medicare payers.

Also, the encounter must meet these requirements before you can choose from the 29000-29799 code set:

- The physician must provide the initial splint or strap, or replace it.

- The physician cannot be reporting fracture care for the same injury. Reader Questions were reviewed by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at UMDNJ-RWJ University Orthopaedic Group in New Brunswick, N.J.; and Bill Mallon, MD, orthopedic surgeon and medical director at Triangle Orthopaedic Associates in Durham, N.C.