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Orthopedic Coding Alert

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97760: Count Post-Op Brace Fitting and Education Separate?

Published on Thu Jan 27, 2011

Question: Can my physician bill for a fitting and education of a brace during the postoperative period for an anterior cruciate ligament (ACL) surgery? I found 97760, but can I report this separately, or is it considered part of the ACL surgery's global period?Answer: The Correct Coding Initiative (CCI) edits do not bundle 97760 (Orthotic[s] management and training [including assessment and fitting when not otherwise reported], upper extremity[s], lower extremity[s] and/or trunk, each 15 minutes) into any of the ACL repair codes, for example 27407 (Repair, primary, torn ligament and/or capsule, knee; cruciate). But this doesn't automatically mean that you can report 97760 in the situation outlined in the question above.According to the December 2005 CPT Assistant, 97760 "includes the provider's time associated with determining the proper orthotic design in relation to the patient's skin integrity, sensibility and healing of tissues with or without surgical repair (e.g., static vs. dynamic, [...]
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