Outpatient Facility Coding Alert

Question: A patient came to the office with severe ankle pain following an injury. The patient said she believed she had a broken ankle. However, following an examination and x-ray, the provider diagnosed a sprained ankle, wrapped the ankle with an ACE bandage and sent the patient home. Can we bill for the bandage in addition to the visit, using 99070?

Codify Subscriber

Answer: You shouldn’t report 99070 (Supplies and materials [except spectacles], provided by the physician or other qualified healthcare professional over and above those usually included with the office visit or other services rendered [list drugs, trays, supplies, or materials provided]).

Instead, you should bill an E/M code for the visit based on what the surgeon documents using a code such as 99213 (Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components …).

In addition, you may separately bill the ACE bandage using a more specific HCPCS code instead of the general supplies code 99070.

Do this: Report S8431 (Compression bandage, roll) or A6448 (Light compression bandage, elastic, knitted/woven, width less than three inches, per yard) as appropriate and per payer guidelines to reflect the ACE bandage that you provided.

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