Wiki Application of Splint in ED.

CHEFFNER

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A patient comes to the emergency room with a broken arm and a short arm splint is applied by the ED physician. Who should bill the 29125 code for application of the splint? The physician or the facility? This has become quite an issue in our coding department.
Thanks for any advice!!
 
Initial Application Splint not Billed

According to the notes under Musculoskeletal System, p.88, and again under Application of Casts and Strapping, p.142, the initial cast/splint or strap application is included in the treatment of fracture and/or dislocation codes. If the physician in this case bills the 29125 this is unbundling and will be denied. Since the hospital is providing the casting/splint or strapping supplies they will bill for those.
 
Splint Application

But if the ED physician is billing an E&M code such as 99284, they can code the splint application in addition to the Level. Sometimes an ED physician will provide initial fracture care and the patient is moved to the OR or sent immediately to an Orthopod. In these cases often a level and splint are coded.
If the physician is applying the splint. this should be billed by the physician not the hospital. The hospital might bill the supply though.

Jim
 
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