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Cpt Codes 29540 Strapping

  1. #1
    Default Cpt Codes 29540 Strapping
    Medical Coding Books
    If your physician using Ace wrap (bandage). For a ankle sprain.
    Is anyone report cpt 29540 for these services.

    Daniel, CPC

  2. #2
    no, wrapping an Ace wrap on an ankle does not qualify for strapping. Its part of the E/M however depending on your contracts you may be able to use the 99070 for the supply of the ace.

  3. #3
    What your saying makes sense.

    But check out this article.

    codinginstitute.com/sample/ica_sample.pdf -

    Here's a bit of what I read out of it.

    Straps Bind Surfaces Together
    To get an idea of what might constitute a strapping encounter, check out this
    experienced coder's opinion: “Payers generally consider strapping the application
    of adhesive tape, one overlapping the other, to provide support and/or restriction of movement of ligament structures by exerting pressure
    upon the extremity or other area of the body,” says Sherry
    Milligan, CPC, coder at West Physician Services in
    Klamath Falls, Ore.

    Strapping requires specialized skill and knowledge of
    the anatomical structures as well as application technique,
    Milligan says.

    Think of it this way: “A strap is something used to
    bind surfaces together or to give support or compress a
    body part (e.g., wrapping an ACE bandage around a
    sprained ankle),” Moore says.

    Consider this example from Moore: An established
    patient reports to the internist after slipping and twisting
    his ankle while jogging. During a level-two E/M service,
    the internist diagnoses a sprained ankle. The internist
    applies a two-foot, two-inch-wide ACE bandage to the
    patient's ankle and foot.

    You should use a strapping code in this scenario. On
    the claim, report the following codes:
    29540 (Strapping; ankle and/or foot) for the
    845.00 (Sprains and strains of ankle; unspecified
    site) attached to 29540 to represent the sprain.
    E885.9 (Fall from other slipping, tripping, or
    stumbling) attached to 29540 to represent the cause of
    the injury.
    99212 (Office or other outpatient visit for the
    evaluation and management of an established patient,
    which requires at least two of these three key components

    Is your answer still the same.

    Daniel, cpc

  4. #4
    Duluth, Minnesota
    frankly... even after reading that - I'd still agree with mborts post, ace bandage is NOT strapping.
    I'd disagree with Moore (whoever that is) AND MORE SO - I'd really hate to be the "yes I coded that ace bandage wrap as a strapping/splint code" end of an audit!!
    I've always known strapping as strategically placed, basically strong sturdy, yet flexible sticky tape - actually works wonders (my husband had to have strapping for a foot/leg issue).
    {that's my opinion on the posted matter}
    Donna, CPC, CPC-H

  5. #5
    Damm, I'm on the fence on this one. Because both answers seem right.
    As of now, I've only used this CPT 29540 strapping of the ankle. In regards to the physician using Buddy tapping.

    I'll wait and see if I get more hits on this question.

    Daniel, CPC

  6. Wink
    If you look under HCPro's website and type in ace wrap in the search engine it states ace wrap/buddy taping doesn't meet the definition of strapping

  7. #7
    Columbia, MO
    The coders desk reference for procedures states that this is typically done with an ACE wrap. It really does not matter what the physician uses to strap the joint with, as that is not what the code is about. The procedure is all about the act of strapping the joint to imobilize it and hold it in correct anatomic position. As long as the physician supplies a procedure note detailing the strapping procedure then I would code it as such without regard to what type of implement was used, tape or ACE wrap.

    Debra A. Mitchell, MSPH, CPC-H

  8. Default
    Ankle sprain:
    Just to ponder only:
    Treatment of Ankle Sprain , whether at home, at wilderness( Medicine), or after same day examination has ruled out other etiologies, is the “PRICE” mnemonic plus range of motion exercise, shoes, and pain relief. Most of us are familiar with PRICE management: Protect, rest, ice, compression/support, elevation. Protection can be an Ace warp, an air cast, and canes or crutches as needed. The rest is relative, encouraging the patient to walk with a normal gait as soon as possible.
    What I am trying to say is this: The bottom line/principle of Protection and Support provided by the Physician, in ankle sprain, whether it is Ace wrap or a tape, is Strapping (only the degree of which varies, and say for an athletes, should be prepared to give up a little comfort for support.)

    So our basic coding is Strapping.
    I do agree with Mitchellde , after having come to know with all the different school of thoughts about it.
    This you can take it as a lay person’s opinion, if not agreeable.
    It is a forum thought can be shared right?
    Thank you for tuning in!
    Last edited by preserene; 10-16-2010 at 11:23 AM.

  9. Default
    The May 2009 CPT Assistant states "Both a knee immobilizer and a sholder immobilizer are considered splints and are described by codes 29505 or 29105. Strapping is the creating of the mechanism that performs the immobilization, not the use, fitting, or training for the application of durable medical equipment. Splint application requires creation of the splint." They always use ace wrap for strapping sprained ankles, but it isn't adhesive plaster strips which is in the description of strapping which is worrysome.

    I'm assuming the statement "splint application requires creation of the splint" means we can no longer code the 29000 splinting series for when no fiberglass or plaster strips/rolls are used by the provider to "create" the splint, just code the hcpcs supply and/or application charge.

    The June 2010 CPT Assistant states "The application of an air splint is not a separately reportable service. The work of performing a strapping technique is very different than applying an off-the-shelf item such as a knee (29540) or shoulder (29240) immobilizer or air splint. The supply of the air splint may be reported with CPT code 99070 or the appropriate HCPCS II code."
    Last edited by riley-waldron; 10-30-2010 at 11:00 AM.

  10. Default Strapping
    In regards to the use of "ace bandage" as strapping, you should all read the AMA CPT Assistant for March 2003 which provides a definitive answer for this, which shows clinical examples for both the hospital and physician office setting. I will not post the article itself here as it is copyrighted by the AMA. However, they do use the example of "a cotton padding and elastic dressing is applied" for a left ankle injury and that CPT-4 code "29540-LT - CODING Examples Clinical Example #1."

    I know this is an issue which goes round and around and has done so for years. The other issue here is that Medicare may not follow this guidance and so your Medicare Administrative Contractor (MAC), Fiscal Intermediary (FI), or Carrier should be contacted for official CMS/Medicare guidance, a policy and procedure created for compliance purposes, and then coding staff trained to follow that policy and procedure.

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