Wiki CPT 29580 Una boot application


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Question - if an established patient coming in for a wound check has a new una boot applied (had 3 others applied around every 7-10 days before this one) for venous HTN with ulcer is it appropriate for the provider to bill both the E/M and the una boot - CPT 29580?

Depends, if there just coming in for the unna boot. Then you would just bill for the unna boot. But if a work up that justifies an E/M then you can bill both.

Daniel. CPC
I would say the supplies are included in cpt 29580 for the unna boot.
But sure some out there might use a hcpcs code for the supplies. Maybe
A4649. Just a thought.

But me personally I'd just code the cpt 29580 for everything.

Per the NCCI rebundling table, the code for Unna boots is component to many other comprehensive surgeries (e.g. tendon sheath injections, joint aspiration/injection, etc.) unless a modifier is appended to reflect the Unna boot was used in a distinct, separate service. Unna boots applied as dressings would not be considered a separately reimbursable service apart from surgical procedure as payment for surgical dressings applied by the physician during his/her encounter with the patient is included in the fee schedule payment for the physician's service. For medically necessary Unna boots not applied as post operative dressings, CPT code 29580 may be billed; but an evaluation and management visit should not be billed unless there is a distinct, separately identifiable reason for the E&M service. It would be inappropriate to bill an E&M service for the assessment related to Unna boot application. The assessment would be considered part of the pre-procedural evaluation that is component to the procedure/service. This is reflected in the following link to CMS Publication 100-4, The Medicare Claims Processing, Chapter 12, and Section 30.6.6. It explains that each procedure includes a pre-procedural evaluation that should not be separately billed as a distinct, separately payable E&M visit.
Can anyone help (thanks)

Does anyone know if the unna boot code, 29580 can or should be used for placing an unna boot on the arm? ...or does anyone know another way to code for placing an unna for ulcers on the arm?

(I found a reference on the LCD: Centers for Medicare & Medicaid Services website that say an unna is "applied to an extremity for..." --any other words, the word extremity is used rather than 'leg'. I'd would appreciate anyone's insights or opinion on whether you think this is appropriate.

Thanks very much!

Warmest regards,
does anyone get paid for the bandages and paste with the unna boot? What codes do you use?
At our clinic, for unna boot supplies (in addition to the application 29580) we use A6456 'zinc paste impregnanted bandage, nonelastic, knitted/woven, width greater than or equal to 3 in and less than 5 in, per yard'. Some insurances pay and some do not.
Rebecca, could you post that link for the medicare publication describing that procedures include a pre-procedural evaluation that should not be separately billed as a distinct, separately payable E&M visit. Thanks so much, Mary