Orthopedic Coding Alert
Insurers Don't Subject Boot to Casting Guidelines
Question: Can we charge for closed treatment of an ankle fracture along with a walker boot (L2114)? We realize that insurers include the initial "strapping or cast" in closed fracture treatment, but because the patient can reuse the boot, we aren't sure whether it falls under the strapping/casting guidelines. Answer: Because the patient can reuse the walker boot, insurers consider it durable medical equipment (DME) and don't include it in the casting and strapping guidelines.
Michigan Subscriber
Therefore, you can report L2114 (AFO, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment) in addition to the global fracture treatment code (e.g., 27530, Closed treatment of tibial fracture, proximal [plateau]; without manipulation).
Orthopedic Coding Alert
- 5 Answers to Your Most Pressing X-Ray Questions
You'll hit your claims on the mark every time with these expert tips If you [...] - E Codes Can Help You Unlock Workers' Comp Pay
Workers' comp insurers may not pay your claim without accident details Workers' compensation claims don't [...] - You Be the Coder:
How Should We Report Olecranon Bone Spur?
Question: Which diagnosis code should we report for an olecranon bone spur? ICD-9 points to [...] - News You Can Use:
CMS Won't Cover Arthroscopic Debridement for Knee OA
You can't report 29877 for osteoarthritis lavage alone, experts say If your orthopedic surgeon performs [...] - Look to the Web for Medicare's Physician Fee Schedule
In the July Orthopedic Coding Alert article "PA Assists at Surgery? 4 Steps Ensure Reimbursement," [...] - Reader Questions:
Use 727.89 for Dislocated Peroneal Tendon Dx
Question: Our orthopedic surgeon recently repaired a patient's peroneal tendon, but we can't find a [...] - Correction:
Report 10180 for Complex Post-op Wound Infection I&D
In the August Orthopedic Coding Alert article "2 Questions Help You Report Postoperative Infections," we [...] - Reader Questions:
Include Graft Harvest in ACL Repair
Question: Which code should I report when the surgeon performs a hamstring autograft with an [...] - Reader Questions:
Insurers Don't Subject Boot to Casting Guidelines
Question: Can we charge for closed treatment of an ankle fracture along with a walker [...] - Reader Questions:
Payers May Sway on DEXA Limits
Question: If we perform a DEXA scan on a patient, and then repeat the DEXA [...] - Reader Questions:
Turn to Unlisted-Procedure Code for Core Decompression
Question: Does CPT include a code for core decompression of the right hip? I haven't [...]
