Splint application

wpienaar

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If a child presents with arm pain after falling from a bed, the provider does an examination and applies a splint and sends the child to the hospital for an xray, is it appropriate to bill the EM code and the splint application code with splint supplies?
 

dballard2004

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Wendy,

I will wager an opinion here.

In the CPT manual, the guidelines state that if a cast or splint is applied as an inital service and the provider does not perform any other treatment or is not expected to provide further treatment, you report the code for the cast/splint application and an E/M code as appropriate. The E/M service will need to be significant and separately identifiable.

You will need to append modifier 25 to the E/M code and use the appropriate HCPCS anatomical modifier (LT/RT) on the splint application code and code the splint supplies. The supplies can be reported with either CPT code 99070 or the correct HCPCS Level II code.

Splint application has no global period per CMS.

As always, I recommend consulting with the payer in question here for further guidance.

Hope this helps and again this is my opinion.
 
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