Ulcer Debridement with TCC

tanzaldua

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Boerne, Texas
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29445 (application of total contact cast) denying/bundling with 11042. Is 59 modifier appropriate in this case? Wound has to be be debrided before cast is applied.
 

podcoder70

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Yes, bill 11042 with appropriate icd10 and then add 29445 with 59 modifier and appropriate icd10.

In CPT Assistant (September 2011), the AMA wrote:

“CPT code 29445, Application of rigid total contact leg cast, is the appropriate code to report for the total contact cast application. A Total Contact Cast (TCC) is used to reduce the pressure and/or shear forces on a lower extremity wound, typically on the plantar surface. The cast improves the ability of the wound to heal. If a wound debridement is performed (codes 11042-11047, 97597/97598), any primary or secondary dressing materials used to cover the wound would be included in the debridement and would not be separately reported. However, a TCC is not considered a wound dressing and is not included in the debridement procedure. Therefore, the cast application should be coded in addition to the code for the appropriate level of debridement, if performed. A TCC application applied on a visit when wound debridement is not performed should be reported with code 29445.”
 
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