Wiki ORTHOGLASS BILLING

[BrandonP0207]

We are an urgent care facility that is privately owned. We use the orthoglass splinting material in our office.

We need some guidance on billing to commercial insurance and Medicare.

We have been using A4590. We have been charging this code by how many inches we used. As working in the hospital setting this was important to document so charges could be applied correctly. However we have now noticed many of the commercial insurances are denying this code.

When doing research I see these codes as well:

Report a CPT code for the application of a splint regardless of whether the splint was off-the-shelf or prefabricated. This applies to the following codes:

• 29105—Application of long arm splint, shoulder to hand
• 29125—Application of short arm splint, forearm to hand; static
• 29126—dynamic
• 29130—Application of finger splint; static
• 29131—dynamic
• 29505—Application of long leg splint, thigh to ankle or toes
• 29515—Application of short leg splint, calf to foot

Does anyone know the most appropriate way to bill for orthoglass and if it is one of the codes starting with 2 - what is the difference between static and dynamic?

Thanks!

 

[KRZollinger67]

We are an urgent care facility that is privately owned. We use the orthoglass splinting material in our office.

We need some guidance on billing to commercial insurance and Medicare.

We have been using A4590. We have been charging this code by how many inches we used. As working in the hospital setting this was important to document so charges could be applied correctly. However we have now noticed many of the commercial insurances are denying this code.

When doing research I see these codes as well:

Report a CPT code for the application of a splint regardless of whether the splint was off-the-shelf or prefabricated. This applies to the following codes:

• 29105—Application of long arm splint, shoulder to hand
• 29125—Application of short arm splint, forearm to hand; static
• 29126—dynamic
• 29130—Application of finger splint; static
• 29131—dynamic
• 29505—Application of long leg splint, thigh to ankle or toes
• 29515—Application of short leg splint, calf to foot

Does anyone know the most appropriate way to bill for orthoglass and if it is one of the codes starting with 2 - what is the difference between static and dynamic?

Thanks!

We use the 29— codes for splint application for Orthoglass. Static is usually what our providers apply as they wish to completely immobilize the area. We are urgent care and therefore stabilize the patyand refer to ortho as needed. We don’t bill the feacture care codes only the splint applications.