CPT code 29058 is for the application of a shoulder cast, used to immobilize and support the shoulder during healing.
CPT code 29058 is used to describe the procedure of applying a cast to the shoulder. This code specifically indicates that the cast is being applied to immobilize the shoulder joint, typically following an injury or surgery, to promote healing and prevent further damage.
When billing for CPT code 29058, which pertains to the application of a shoulder 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 50 - Bilateral Procedure: Use this modifier if the procedure is performed on both shoulders.
2. Modifier LT - Left Side: Use this modifier if the procedure is performed on the left shoulder.
3. Modifier RT - Right Side: Use this modifier if the procedure is performed on the right shoulder.
4. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required, justifying additional reimbursement.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated on the same shoulder by the same provider on the same day.
6. Modifier 59 - Distinct Procedural Service: Use this modifier if the procedure is performed separately from other procedures on the same day, indicating that it is not part of a bundled service.
7. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Use this modifier if the procedure is repeated for diagnostic purposes, although this is less common for casting procedures.
8. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
Each of these modifiers serves to provide additional context for the procedure performed, ensuring accurate billing and reimbursement in accordance with the specific circumstances surrounding the service.
The CPT code 29058 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, reimbursement can vary based on the region, as Medicare Administrative Contractors (MACs) may have specific guidelines and policies that influence coverage and payment. Therefore, it is advisable to consult the MPFS and the relevant MAC for the most accurate and up-to-date information regarding the reimbursement of CPT code 29058.
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