CPT CODES

CPT Code 29445

CPT code 29445 is used for billing the application of a rigid leg cast in healthcare settings.

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What is CPT Code 29445

CPT code 29445 is used to describe the procedure of applying a rigid leg cast. This code specifically refers to the process of immobilizing a leg fracture or injury by encasing the affected area in a hard cast, which helps to stabilize the bone and promote healing. The application of this cast is typically performed by a healthcare professional, ensuring that the cast is properly fitted and secured to provide adequate support to the injured leg.

Does CPT 29445 Need a Modifier?

When billing for the CPT code 29445 (Apply rigid 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 procedure is performed on both legs.

2. Modifier 51 - Multiple Procedures: This modifier is applicable if the cast application is performed in conjunction with other procedures on the same day.

3. Modifier 59 - Distinct Procedural Service: This modifier should be used if the cast application is performed on a different site or if it is a separate procedure from other services provided on the same day.

4. Modifier LT - Left Side: Use this modifier if the cast is applied to the left leg.

5. Modifier RT - Right Side: Use this modifier if the cast is applied to the right leg.

6. Modifier 76 - Repeat Procedure by Same Physician: This modifier is appropriate if the cast application is repeated on the same leg by the same provider on the same day.

7. Modifier 77 - Repeat Procedure by Another Physician: Use this modifier if the cast application is performed by a different physician on the same leg on the same day.

8. Modifier 22 - Increased Procedural Services: This modifier may be used if the complexity of the cast application is significantly greater than typically required.

9. Modifier 32 - Mandated Services: This modifier is applicable if the cast application is required by a third party, such as an insurance company or legal entity.

10. Modifier 53 - Discontinued Procedure: Use this modifier if the procedure was started but not completed due to extenuating circumstances.

It is essential to select the appropriate modifier(s) based on the specific details of the procedure to ensure accurate billing and reimbursement.

CPT Code 29445 Medicare Reimbursement

The CPT code 29445 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 can vary based on the region, as Medicare Administrative Contractors (MACs) may have different policies and rates.

Therefore, it is advisable to consult the relevant MAC for your geographic area to confirm the exact reimbursement details for CPT code 29445.

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