Primary Care Coding Alert

Question: A preschool child catches his finger in a car door. My family physician (FP) examines only the patient's hand and determines the child simply sprained and bruised the finger. He also applies a finger splint for the child's comfort. May I report an office visit in addition to the splint application?

Illinois Subscriber
Answer: Yes, you may report the E/M service and the splint application. The FPapplies the splint as an initial service in which he performs no other procedure or treatment. In this case, CPTindicates you should "use the casting, strapping, and/or supply code in addition to an evaluation and management code as appropriate."

Therefore, you should report three codes for the above claim. Use 29130 (Application of finger splint; static) as the strapping code. To indicate that the E/M service is a significant, separately identifiable service from the splint application, 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 office visit code (99201-99215, Office or other outpatient visit for the E/M of a new or established patient ...). For the splint, you should report either A4570 (Splint) or 99070 (Supplies and materials ...) depending on whether the payer accepts alphanumeric HCPCS codes.