CPT code 29000 is for the application of a body cast, used to immobilize and support a specific body part during healing.
CPT code 29000 is used to describe the procedure of applying a body cast. This code specifically refers to the process of immobilizing a part of the body, typically to support healing after a fracture or injury. The application of a body cast involves encasing the affected area in a rigid material, ensuring stability and protection during the recovery period.
When billing for CPT code 29000 (Application of body cast), several modifiers may be applicable depending on the specific circumstances of the procedure. Here is a list of potential modifiers that could be used:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the application of the body cast required significantly more work than typically required for the procedure.
2. Modifier 50 - Bilateral Procedure: If the body cast is applied to both sides of the body, this modifier indicates that the procedure was performed bilaterally.
3. Modifier 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the body cast application is performed more than once on the same day by the same provider.
4. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if a different physician performs the body cast application on the same day.
5. Modifier 59 - Distinct Procedural Service: This modifier can be used to indicate that the body cast application is separate and distinct from other procedures performed on the same day.
6. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: If applicable, this modifier indicates that the procedure was repeated for the purpose of monitoring or follow-up.
7. Modifier KX - Requirements Met: This modifier is used to indicate that the requirements for coverage of the procedure have been met, particularly in the context of Medicare.
8. Modifier 52 - Reduced Services: If the body cast application was performed but was less extensive than usual, this modifier may be appropriate.
Each of these modifiers serves to provide additional context to the procedure performed, ensuring accurate billing and compliance with payer requirements.
The CPT code 29000 is reimbursed by Medicare, but it is essential to verify its specific reimbursement rate and coverage details through the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, Medicare Administrative Contractors (MACs) play a crucial role in determining local coverage decisions and processing claims. Therefore, it is advisable to consult the relevant MAC for your region to ensure compliance with local policies and obtain accurate reimbursement information for CPT code 29000.
Discover how MD Clarity's RevFind software can enhance your revenue cycle management by accurately reading your contracts and detecting underpayments down to the CPT code level and by individual payer. For instance, with CPT code 29000, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
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