Wiki 3 finger fractures same hand

[bethb]

Hi. I am hoping someone can help me with this one. The patient was diagnosed with 3 fractured fingers of the right hand: the index finger, the long finger, and the ring finger. Closed treatment without manipulation was done for each fracture. 2 splints were applied: one splint for the long finger and one splint for the ring finger. Can 3 separate lines of 26750 be reported? The wording of the CPT code has "each", and 2 separate splints were used. Is 26750 x 3 units correct? Or will it be 1 unit of 26750?

Thanks in advance!

Beth

 

[daedolos]

Just bill 26750-F6, 26750-F7, and 26750-F8

Peace
@_*

 

[Orthocoderpgu]

If payor follows CMS you will not be able to bill for all three fractures

Per the CMS NCCI Surgery policy manual for orthopedics if a single cast/splint treats more than one fracture, only one fracture can be billed. The confusion starts on page 10.

Other significant updates this year is that:

29822 is bundled into all shoulder procedures.

29823 can only be billed with 29824, 29827 & 29828

29877 can only be billed if it is the only procedure billed.

29874 can only be billed if its the only procedure billed.

 

[daedolos]

Cripes.

Peace
@_*
Thanks for the info. But 26750 is a closed treatment code, not a cast/splint code.

 

[MI_CODER]

Based on the info you provided, I would code it as 26750-F6, 26750-F7 and 26750-F8. Because you have a 3 separate fractures that are being treated (index, middle and ring) you can code 26750 x3. You need to add the modifiers to specify which fingers were treated.

Per the Coder's Desk Reference, the description for CPT 26750 is as follows:

The physician treats distal phalangeal fracture of the finger or thumb with or without manipulation. In 26750, no manipulation is necessary. In 26755, the physician manipulates the bones to restore anatomical position. The hand is splinted for stabilization.