CPT code 29345 is a medical billing code used for the application of a long leg cast in healthcare settings.
CPT code 29345 is used to describe the procedure of applying a long leg cast. This code indicates that a healthcare provider has immobilized a patient's leg, typically to treat fractures, severe sprains, or other injuries. The application of a long leg cast involves encasing the leg from the toes to above the knee, ensuring proper alignment and stabilization during the healing process.
When billing for CPT code 29345 (Application of long leg 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 long leg cast is applied to both legs.
2. Modifier -RT: Right Side
- Use this modifier if the procedure is performed on the right leg.
3. Modifier -LT: Left Side
- Use this modifier if the procedure is performed on the left leg.
4. Modifier -59: Distinct Procedural Service
- Use this modifier if the application of the long leg cast is performed separately from other procedures on the same day.
5. Modifier -76: Repeat Procedure by Same Physician
- Use this modifier if the long leg cast is reapplied or adjusted by the same physician on the same day.
6. Modifier -77: Repeat Procedure by Another Physician
- Use this modifier if the long leg cast is reapplied or adjusted by a different physician on the same day.
7. Modifier -22: Increased Procedural Services
- Use this modifier if the procedure required significantly more work than typically required for the application of a long leg cast.
8. Modifier -GC: Teaching Physician Service
- Use this modifier if the procedure was performed by a resident under the supervision of a teaching physician.
9. Modifier -QK: Medical Direction of Two or More Concurrent Anesthesia Procedures
- Use this modifier if the procedure is part of a medical direction scenario involving anesthesia.
10. Modifier -KX: Requirements Met
- Use this modifier to indicate that the specific requirements for coverage have been met, particularly for Medicare claims.
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 29345 is reimbursed by Medicare, but the reimbursement is subject to specific conditions outlined in the Medicare Physician Fee Schedule (MPFS). The MPFS provides a comprehensive list of services covered by Medicare and the corresponding payment rates.
Additionally, the reimbursement for CPT code 29345 may vary depending on the region, as Medicare Administrative Contractors (MACs) have the authority to make local coverage determinations. Therefore, it is essential to consult the relevant MAC for your region to confirm the specific reimbursement details and any additional requirements that may apply.
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