CPT code 29085 is used to describe the procedure of applying a cast to the hand or wrist for treatment of injuries.
CPT code 29085 is used to describe the procedure of applying a cast to the hand or wrist. This code specifically indicates that a healthcare provider is immobilizing the hand or wrist area to promote healing, typically after an injury or surgery. The application of this cast is essential for ensuring proper alignment and support during the recovery process.
When billing for the CPT code 29085 (Apply hand/wrist 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
- Used when the procedure is performed on both hands or wrists.
2. Modifier -RT: Right Side
- Indicates that the procedure was performed on the right hand or wrist.
3. Modifier -LT: Left Side
- Indicates that the procedure was performed on the left hand or wrist.
4. Modifier -59: Distinct Procedural Service
- Used to indicate that the procedure is separate and distinct from other services performed on the same day.
5. Modifier -76: Repeat Procedure by Same Physician
- Indicates that the procedure was repeated by the same physician on the same day.
6. Modifier -77: Repeat Procedure by Another Physician
- Indicates that the procedure was repeated by a different physician on the same day.
7. Modifier -22: Increased Procedural Services
- Used when the procedure required significantly more work than typically required.
8. Modifier -GC: Teaching Physician Service
- Indicates that the service was performed under the direction of a teaching physician.
9. Modifier -KX: Requirements Met
- Used to indicate that the service meets the criteria for coverage.
10. Modifier -AS: Physician Assistant/ Nurse Practitioner/ Clinical Nurse Specialist
- Indicates that the service was performed by a non-physician practitioner.
It is essential to select the appropriate modifier(s) based on the specific circumstances of the procedure to ensure accurate billing and compliance with payer requirements.
The CPT code 29085 is reimbursed by Medicare, but it is essential to verify the specific reimbursement 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, it is crucial to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing guidelines that may affect reimbursement for CPT code 29085.
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