CPT code 29126 is used to describe the procedure of applying a forearm splint for immobilization and support.
CPT code 29126 is used to describe the procedure of applying a forearm splint. This code indicates that a healthcare provider has immobilized a patient's forearm using a splint, typically to support a fracture, sprain, or other injury. The application of the splint is essential for promoting healing and preventing further injury to the affected area.
When billing for the CPT code 29126 (Apply forearm splint), the following modifiers may be applicable:
1. Modifier 50 - Bilateral Procedure: Use this modifier if the splint is applied to both forearms.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if the splint application is performed alongside other procedures during the same session.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used if the splint application is performed on a different site or for a different reason than other procedures billed on the same day.
4. Modifier LT - Left Side: Use this modifier if the splint is applied to the left forearm only.
5. Modifier RT - Right Side: Use this modifier if the splint is applied to the right forearm only.
6. Modifier KX - Requirements Met: This modifier indicates that the requirements for coverage of the splint have been met, which may be necessary for certain payers.
7. Modifier GA - Waiver of Liability Statement on File: This modifier is used when a provider believes that a service may not be covered by Medicare, and a waiver of liability has been signed by the patient.
8. Modifier GY - Item or Service Not Covered: This modifier indicates that the service is not a covered benefit under the payer's policy.
Each of these modifiers serves a specific purpose in clarifying the circumstances under which the splint application was performed, ensuring accurate billing and reimbursement.
The CPT code 29126 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) to determine the specific reimbursement rate.
The MPFS provides a comprehensive list of services covered by Medicare and their corresponding payment amounts.
Additionally, reimbursement for CPT code 29126 may vary depending on the local policies of the Medicare Administrative Contractor (MAC) that services your region.
Each MAC has the authority to implement specific guidelines and coverage determinations, so it is advisable to consult your regional MAC for precise information regarding the reimbursement of CPT code 29126.
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. With RevFind, you can identify discrepancies for CPT code 29126 and ensure you are receiving the correct reimbursement. Schedule a demo today to see how our solution can help you maximize your revenue.
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