Orthopedic Coding Alert

Question: Our hand surgeon treated a patient's metacarpal fracture and splinted the finger. Can we separately report the splinting code as well as the fracture care code? I know casting is included in fracture care but I don't know about splinting.

Tennessee Subscriber

Answer: The relative value units for the fracture care codes (such as 26600, Closed treatment of metacarpal fracture, single; without manipulation, each bone) already include the cost of the first splinting for a fracture care patient, so you shouldn't report splinting separately.

You can report a second splinting (29130, Application of finger splint; static) if your hand surgeon finds it medically necessary to take off the first splint and replace it with a new one.

Good idea: During the second visit, your hand surgeon may provide and document enough information to report an E/M service (99211-99215), but you should append modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the appropriate-level established patient code if you report both the E/M and the splinting code.