Billing 29125 and 29260 together

[miugu]

If a physician applies a wrist ready made splint and then an ace bandage to the same wrist, can 29125 and 29260 both be billed and, if so, does 29260 require modifier 51?

Thank you

 

[britbrit852003]

The definition of the 29125 is-
The physician applies a splint from the forearm to the hand. A short arm splint is used to immobilize the wrist. Cotton padding is applied from midforearm to the midpalm region. Plaster strips or fiberglass splint material are applied along the palm side of the hand, extending to midforearm, maintain the wrist in the desired position. An Ace wrap is applied by the physician to hold the splint material in position. Report 29125 if the splint is static, keeping the wrist totally immobilized. Report 29126 if the splint is dynamic, allowing some movement.
in your question you said it was a "ready made" splint and that sounds like a premade out of a box type splint not a splint they make like described above.
You cannot bill an application fee for premade "ready made" splints.

I also do not think 29260 is the appropriate code for the ace wrap application as the definitionj of that code is: The physician or a medical professional under the physician's direction performs strapping with tape on a patient of any age.
An ace wrap is not considered tape in this case.

So in your case I think you would just charge an E/M and two HCPCS codes for the splint and ace wrap.

 

[miugu]

Thank you for the answer.

 

[miugu]

What if the carrier doesn't accept HCPCS codes?

Thank you

 

[britbrit852003]

I'd suggest calling that carrier and asking what codes they accept in place the HCPCS.
At my practice Aetna does not accept any HCPCS that start with A instead they want all L codes.