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Wiki Need help with splint coding

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KarenRKasper

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My doctor applied 2 splints on a patient and insists on billing for 2 splints. Insurance denies the 2nd splint as a duplicate proceedure and the office manager insists I do something to get paid for the 2nd splint. How should I properly bill this? :confused:

Ex: Patients 1st visit. "Patient was placed in a short leg horseshoe and posterior OCL splints." He had us bill DX codes 824.02 Salter I distal fibula fracture and 845.02 Ankle sprain.
99244-25
73610-22 4 views instead of 3
29515 x 2
& E0114

Your help will be greatly appreciated.
Karen Kasper
 
you would not use a 22 on the 76310 just because you did 4 views, the code is for a MINIMUM of 3 views so it is good as it is for anything over 3, also you should never bill the 29515 with greater than 1 unit, if you applied 2 separate splints to 2 separate areas then you bill the code twice with the 59 modifier. without more of the documentation I cannot say if your codes are correct or not and if your dx is correct or not. did the patient have a fx and a sprain? If not then you cannot use both codes If this is the same area then you must chose whether it is a fx or a sprain. If it is 2 separate injuries then you will need that clearly documented along with the procedure note showing 2 separate injuries being addressed and treated.
 
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