CPT code 29355 is for the application of a long leg cast, used to immobilize and support fractures or injuries in the leg.
CPT code 29355 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 or severe soft tissue injuries, by encasing it in a rigid cast that extends from the foot to above the knee. The application of this cast is essential for proper healing and stabilization of the affected area.
When billing for CPT code 29355 (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 during the same session.
2. Modifier 51 - Multiple Procedures: This modifier is appropriate if the application of the long leg cast is performed alongside other procedures during the same visit.
3. Modifier 59 - Distinct Procedural Service: This modifier should be used if the long leg cast application is performed on a separate site or if it is distinct from other services provided on the same day.
4. Modifier LT - Left Side: Use this modifier if the long leg cast is applied specifically to the left leg.
5. Modifier RT - Right Side: Use this modifier if the long leg cast is applied specifically to the right leg.
6. Modifier 22 - Increased Procedural Services: This modifier may be applicable if the complexity of the cast application significantly exceeds the usual service, warranting additional reimbursement.
7. Modifier 76 - Repeat Procedure by Same Physician: This modifier is relevant if the long leg cast is reapplied or adjusted by the same physician on the same day.
8. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if a different physician applies the long leg cast on the same day.
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 application of the long leg cast.
The CPT code 29355 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 advisable to consult with your regional Medicare Administrative Contractor (MAC) to confirm any local coverage determinations or specific billing requirements that may affect reimbursement for CPT code 29355.
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. For instance, with CPT code 29355, you can ensure that you are receiving the correct reimbursement for your services. Schedule a demo today to see how RevFind can help you identify and address underpayments effectively.
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