CPT code 29435 is used to describe the procedure of applying a short leg cast for immobilization of a lower limb injury.
CPT code 29435 is used to describe the procedure of applying a short leg cast. This code specifically refers to the immobilization of the lower leg, typically from the foot to just below the knee, using a cast to support and protect a fracture or injury. The application of this cast is crucial for proper healing and stabilization of the affected area.
When billing for the CPT code 29435 (Apply short 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. -50: Bilateral Procedure
- Used when the procedure is performed on both legs.
2. -LT: Left Side
- Indicates that the procedure was performed on the left leg.
3. -RT: Right Side
- Indicates that the procedure was performed on the right leg.
4. -22: Increased Procedural Services
- Used when the procedure requires significantly more work than typically required.
5. -59: Distinct Procedural Service
- Indicates that the procedure is distinct or independent from other services performed on the same day.
6. -76: Repeat Procedure by Same Physician
- Used when the procedure is repeated by the same physician on the same day.
7. -77: Repeat Procedure by Another Physician
- Used when the procedure is repeated by a different physician on the same day.
8. -91: Repeat Clinical Diagnostic Laboratory Test
- Used when the procedure is repeated for diagnostic purposes.
9. -GC: Graduate Medical Education (GME) Modifier
- Indicates that the service was performed by a resident under the supervision of a teaching physician.
10. -QZ: Service Furnished by a Nurse Practitioner or Physician Assistant
- Used when the service is provided by a non-physician practitioner.
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 service.
The CPT code 29435 is reimbursed by Medicare, but it is essential to verify its inclusion in the Medicare Physician Fee Schedule (MPFS) for the specific year in question. The MPFS provides a comprehensive list of services covered by Medicare and their corresponding reimbursement rates.
Additionally, reimbursement can vary based on the policies of the Medicare Administrative Contractor (MAC) for your region. Each MAC may have specific guidelines and coverage determinations that could affect whether CPT code 29435 is reimbursed.
Therefore, it is advisable to consult the MPFS and your regional MAC for the most accurate and up-to-date information.
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 specific codes like 29435, ensuring you capture every dollar owed. Schedule a demo today to see how RevFind can streamline your financial processes and improve your bottom line.
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
