Podiatry Coding & Billing Alert

Question: The podiatrist saw an established patient who complained of ankle pain in his right foot after falling and twisting his foot in the shower. The podiatrist performed a level two E/M and diagnosed the patient with a sprained ankle. The podiatrist then applied a splint to the patient's sprained ankle. Can you tell me which codes to use?

Ohio Subscriber

Answer: You will report the following codes in this scenario:

• 29515 (Application of short leg splint (calf to foot))
• S93.401A (Sprain of unspecified ligament of right ankle, initial encounter) as the diagnosis code to support the splinting code
• W18.2XXA (Fall in (into) shower or empty bathtub, initial encounter) linked to the splinting code to show the cause for injury
• 99212 (Office or other outpatient visit for the evaluation and management of an established patient...) to report the level-two E/M service. Attach modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) to 99212 to support separately billing the E/M service.
• 99070 (Supplies and materials (except spectacles), provided by the physician or other qualified health care professional over and above those usually included with the office visit or other services rendered (list drugs, trays, supplies, or materials provided)) or A4570 (Splint) for the splint, depending on the payer's preference for supply coding.