Internal Medicine Coding Alert
Don't Sweat Global on Boot Dressing Changes
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Question: A new Medicare patient with a diagnosis of postphlebitic syndrome reports to the internist for Unna boot fitting. The internist places the Unna boot on the patient, and directs her to return in four days for a change of dressing. Four days later, the patient returns and a licensed nonphysician practitioner (NPP) changes the dressing and sends the patient home. How should I code these encounters? Is the second visit an E/M? Florida Subscriber Answer: You should code both visits with the Unna boot code; on the claim, report the following: • 29580 (Strapping; Unna boot) for the initial fitting Reasoning: CPT instructs coders to use 29580 for both Unna boot application and dressing change. The code has a global period of zero days, so you do not need to worry about frequency edits.
• 29580 for the change of dressing
• 459.10 (Postphlebitic syndrome without complications).
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