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casting vs splint

  1. Question casting vs splint
    Medical Coding Books
    Dr A insists that he should be billing 29515 when casting for orthotics. I have explained that this is an immobilization splint and not appropriate. I have suggested that he bill with 29799.

    Because Dr B (an acquaintance that is involved with medical review for "all of the major California Insurers") states that this constitutes 29515 - he insists that this is the correct way to code.

    I have quoted two other doctors (both VERY involved with Medical review for the insurance companies) and still can't persuade him against this. His theory? I've billed this way before and gotten paid - it must be correct.

    Please, can you give me anything else to present to him?
    ~Ursula, CPC~

  2. Default
    I know this answer really does not help you but I personally would tell him........ I realize you may have gotten paid before in the past, but this is totally incorrect billing and billing this here on out knowing it is incorrect is fraudlent.

  3. #3
    Phoenix, AZ
    Here's a link to an article on Orthotics coding and other issues regarding orthotics from Podiatry today. Hope it helps:

    Good luck!
    Cyndi Allen, CPC, CIRCC
    2015 Local Chapter President, Casa Grande, AZ

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