Pediatric Coding Alert

Question: Can we code for a colle wrist splint? If so, how do I choose between CPT and HCPCS supply codes?

Indiana Subscriber

Answer: HCPCS supply codes are more specific than their CPT counterparts, so report L3908 (Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, includes fitting and adjustment) if the payer allows. Otherwise, submit the general CPT supply code 99070 (Supplies and materials [except spectacles], provided by the physician over and above those usually included with the office visit or other services rendered [List drugs, trays, supplies, or materials provided]) with the splint name or serial code in line 19.

Caution: Medicare requires the provider to have a durable medical equipment (DME) number before using HCPCS codes. Private payers may have the same expectation. If you don't have a DME number, supplying the splint will be a non-payable service for Medicare or other payers that follow those guidelines.

 -- Information and/or answers for You Be the Coder and Reader Questions provided and/or reviewed by Richard Tuck, MD, FAAP, pediatrician at PrimeCare of Southeastern Ohio in Zanesville.