Sara Posted Tue 09th of October, 2012 17:29:18 PM
Any help please..
My Dr is asking if we've been billing for "bunion strapping". Im thinking he might be talking about strapping of the toes"29550" and/or foot"29540".
Is this correct or is there another code that I might be missing and shouldnt be?
Thanks so much in advance for any help!
SuperCoder Answered Tue 09th of October, 2012 18:49:26 PM
If your podiatrist is doing the strapping in coordination with fracture care, injury, or dislocation treatment, you’re not going to be able to separately report 29540 (Strapping; ankle and/or foot).
Reason: CPT guidelines state that you can separately report 29540 “when the cast application or strapping is an initial service performed without a restorative treatment or procedure(s) to stabilize or protect a fracture, injury, or dislocation and/or to afford comfort to a patient.” Unfortunately, payers have yet to form a consensus on interpretation of this guideline.
For example, if your podiatrist uses a cortisone injection for plantar fasciitis (20550) and then uses strapping to further alleviate pain, you may be able to get paid for both procedures since a cortisone injection is not really “restoring” the plantar fascia, and since both the injection and the strapping provide a different therapeutic effect.
Need to unbundle: In this case, you would list 20550 in line 1 of #24D of the claim form and then list 29540 with modifier 59 (Distinct procedural service) in line 2 of #24D. Because NCCI edits make 29540 a component part of 20550, modifier 59 lets your payer know that these are distinct services. Both procedure codes would be linked to the same diagnosis code, 728.71 (Plantar fascial fibromatosis).
If strapping is not done in conjunction with “a restorative treatment,” you should have a fighting shot at reimbursement, but your payer may disagree on your definition of restoration. Unless your carrier has a specific written guideline that bans the dual reporting of the specific nonrestorative procedure and strapping, you may opt to move forward with an appeal.