Pediatric Coding Alert

Question: A patient reports with a swollen right ring finger that she injured while catching a softball. Our pediatrician interpreted an x-ray of the hand (two views; results negative), then to stabilize the finger performed strapping with a 3-inch wide ACE bandage with web roll and several layers of tape. Can we report the bandage supply in addition to the CPT^® procedure codes?

Nevada Subscriber

Answer: If you’ve performed the service in your office, you cannot report the ACE bandage supply. You’ll also want to make sure that your payer considers this a strapping procedure before filing the claim.

Remember: To some payers, wrapping a digit with an ACE bandage does not constitute strapping. These payers will want to see the proper level evaluation and management (E/M) code for the service rather than the strapping code. If you are unsure of your payer’s policy on strapping claims, contact a representative before filing this claim.

If your payer considers ACE bandage wrapping strapping, you should:

·         Report 73120-26 (Radiologic examination, hand; two views; Professional component) for the x-ray interpretation

·         Report 29280 (Strapping; hand or finger) for the strapping (supplies are included).

·         Attach ICD-9 code 842.10 (Sprain of unspecified site of hand) to 73120 and 29280 to represent the patient’s injury.

·         Attach ICD-9 code E917.0 (Striking against or struck accidentally in sports without subsequent fall) code to 73120 and 29280 to represent the cause of the patient’s injury.

Note: If you are using a splint, this typically is considered durable medical equipment (DME) and is not billable unless you are a contracted DME provider.