Wiki Ulcer Debridement with TCC

tanzaldua

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29445 (application of total contact cast) denying/bundling with 11042. Is 59 modifier appropriate in this case? Wound has to be be debrided before cast is applied.
 
Yes, bill 11042 with appropriate icd10 and then add 29445 with 59 modifier and appropriate icd10.

In CPT Assistant (September 2011), the AMA wrote:

“CPT code 29445, Application of rigid total contact leg cast, is the appropriate code to report for the total contact cast application. A Total Contact Cast (TCC) is used to reduce the pressure and/or shear forces on a lower extremity wound, typically on the plantar surface. The cast improves the ability of the wound to heal. If a wound debridement is performed (codes 11042-11047, 97597/97598), any primary or secondary dressing materials used to cover the wound would be included in the debridement and would not be separately reported. However, a TCC is not considered a wound dressing and is not included in the debridement procedure. Therefore, the cast application should be coded in addition to the code for the appropriate level of debridement, if performed. A TCC application applied on a visit when wound debridement is not performed should be reported with code 29445.”
 
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