Unna Boot application by nurse

[Ltoth]

We code in the state of New York. The question is...... can we bill for the application of a Unna boot by the nurse? We are a Family Practice Clinic.

Thanks for your help.

Lisa;-)

[ggmaui]

We bill the unna by the nurse but no o/v if the dr. is not here, if he is he always goes in checks the unna and the status of the ulcers, then we charge for o/v and unna.

[RebeccaWoodward*]

Unna Boots

Q: When are Unna boots separately payable? Can an evaluation and management visit with modifier 25 also be billed?

A: :Per the NCCI rebundling table, the code for Unna boots ( CPT code 29580) is component to many other comprehensive surgeries (e.g. tendon sheath injections, joint aspiration/injection, etc.) unless a modifier is appended to reflect the Unna boot was used in a distinct, separate service. Unna boots applied as dressings would not be considered a separately reimbursable service apart from surgical procedure as payment for surgical dressings applied by the physician during his/her encounter with the patient is included in the fee schedule payment for the physician's service. For medically necessary Unna boots not applied as post operative dressings, CPT code 29580 may be billed; but an evaluation and management visit should not be billed unless there is a distinct, separately identifiable reason for the E&M service. It would be inappropriate to bill an E&M service for the assessment related to Unna boot application. The assessment would be considered part of the pre-procedural evaluation that is component to the procedure/service. This is reflected in the following link to CMS Publication 100-4, The Medicare Claims Processing, Chapter 12, and Section 30.6.6. It explains that each procedure includes a pre-procedural evaluation that should not be separately billed as a distinct, separately payable E&M visit.

Many of our carriers follow this same process~

[KGrinley]

Hello
we are a multi specialty practice in NH - when our nurses see patients for application of Unna boots - what is the correct code to charge? would we charge 29850 or for the supply A6456? Would the charge be different if the physician looked in on the patient after the application?
Thank you