Wiki Calling all spine coders!!!!!!!!!!!!!!!!!

[banderson77]

Having a major debate for years in my office and I would so love help to finally solve it. My practice supplies braces for patients. Our debate is this:

22305- Closed treatment of vertebral process fracture(s)

22310 Closed treatment of vertebral process Fracture(s), without manipulation, requiring and including casting or bracing

Can we bill 22310 if we prescribe a brace but the patient does not receive it? Or does it mean that the patient must get the brace?

Please help!!!!!!!!!!!!! I need this debate over with. Thanks!

 

[penguins11]

The patient would have to get the brace. Also, simply prescribing and giving the patient a brace isnt enough to code this, the dr. should dictate a report stating that the brace was given to the patient, he personally fitted the patient not a sales rep, and also some sort of plan stating how he is treating the patient. (Just like he would dictate any other procedure.) It might be more cost effective not to bill 22310, just bill for the follow up office visits depending on how many times you patients usually will have to follow up. 22310 has a 90 day global, you might be better off just billing for the brace and you follow up office visits.