ED Coding and Reimbursement Alert

Question: A patient presented in the ED with a  diagnosis of "ankle sprain." The ED documentation states that the patient received an x-ray and that the physician found no fracture. The ED physician also applied Ace wrap and examined the ankle postapplication, noting that N/V was intact and the bone was properly aligned. In addition to reporting the appropriate E/M code with modifier -25 (Significant, separately identifiable E/M  service ...), would I be correct to code the application of the Ace wrap?
      
New Mexico Subscriber

Answer: When you code the physician's services, application of an Ace wrap does not qualify as splinting. The procedure may qualify as strapping, in which case you should report 29540 (Strapping; ankle and/or foot), but most carriers have a minimal threshold that stipulates the physician perform something more substantial than application of an Ace wrap, tape or web roll. Ask your payer what it will accept.