CPT code 29358 is used to describe the application of a long leg cast brace for patients needing immobilization.
CPT code 29358 is used to describe the procedure of applying a long leg cast brace. This code indicates that a healthcare provider has immobilized a patient's leg, typically to support healing after an injury or surgery. The long leg cast brace extends from the thigh to the foot, providing stability and protection to the affected area.
When billing for the CPT code 29358 (Apply long leg cast brace), 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 legs.
2. Modifier LT - Left Side: Use this modifier to indicate that the procedure was performed on the left leg.
3. Modifier RT - Right Side: Use this modifier to indicate that the procedure was performed on the right leg.
4. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required.
5. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the procedure is repeated on the same leg by the same provider on the same day.
6. Modifier 59 - Distinct Procedural Service: Use this modifier if the procedure is performed separately from other procedures on the same day.
7. Modifier 91 - Repeat Clinical Diagnostic Laboratory Test: Use this modifier if the procedure is repeated for diagnostic purposes.
8. Modifier 52 - Reduced Services: Use this modifier if the procedure was partially reduced or eliminated at the physician's discretion.
Each of these modifiers serves to provide additional context for the billing process, ensuring accurate reimbursement and compliance with payer requirements.
The CPT code 29358 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 is a comprehensive listing of fees used by Medicare to pay doctors or other providers/suppliers.
Additionally, the reimbursement for CPT code 29358 may vary based on the region and the specific Medicare Administrative Contractor (MAC) responsible for processing claims in that area. Each MAC has the authority to interpret Medicare policies and determine the local coverage and payment policies, so it is advisable to consult the relevant MAC for precise information regarding reimbursement.
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 29358, RevFind identifies discrepancies that could impact your bottom line. Schedule a demo today to see how our solution can help you recover lost revenue and ensure you are getting paid what you deserve.
Get paid in full by bringing clarity to your revenue cycle
Subscribe to the
Healthcare Clarified newsletter
Get the latest insights on RCM and healthcare policy in your inbox
