CPT code 29065 is for the application of a long arm cast, used to immobilize and support fractures or injuries in the arm.
CPT code 29065 is used to describe the procedure of applying a long arm cast. This code indicates that a healthcare provider has immobilized a patient's arm, typically from the elbow to the hand, using a cast to support and protect the injured area during the healing process.
When billing for CPT code 29065, which pertains to the application of a long arm 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 arms.
2. Modifier 51 - Multiple Procedures: This modifier is applicable if the long arm cast application is performed in conjunction with other procedures on the same day.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used if the cast application is performed on a different site or for a different diagnosis than other procedures performed on the same day.
4. Modifier LT - Left Side: Use this modifier if the long arm cast is applied to the left arm.
5. Modifier RT - Right Side: Use this modifier if the long arm cast is applied to the right arm.
6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the cast application is repeated on the same arm by the same physician on the same day.
7. Modifier 77 - Repeat Procedure by Another Physician: This modifier is used if the cast application is performed again by a different physician on the same day.
8. Modifier 22 - Increased Procedural Services: This modifier may be used if the complexity of the cast application significantly exceeds the usual service.
9. Modifier 32 - Mandated Services: This modifier is applicable if the cast application is required by a third party, such as an insurance company or legal entity.
10. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure was started but not completed due to extenuating circumstances.
It is essential to select the appropriate modifier(s) based on the specific details of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 29065 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC).
The MPFS provides detailed information on the reimbursement rates and guidelines for various CPT codes, including 29065. Additionally, MACs may have specific local coverage determinations (LCDs) that could affect reimbursement.
Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 29065.
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