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Casts, Splints, and Strapping CPT Codes:: ND D H S M S D

This document provides Medicaid coding guidelines for casts, splints, and strapping. It states that when a surgical procedure on the musculoskeletal system is performed and a cast, splint, or strapping is applied, there is no separate billing allowed for the initial application. It allows for billing of cast supplies with Q codes. It also provides guidance on billing codes for replacement casts, splints, or strapping and visit codes when unrelated problems are addressed at the same time. Covered ICD-9 diagnosis codes must accompany claims.

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602 views1 page

Casts, Splints, and Strapping CPT Codes:: ND D H S M S D

This document provides Medicaid coding guidelines for casts, splints, and strapping. It states that when a surgical procedure on the musculoskeletal system is performed and a cast, splint, or strapping is applied, there is no separate billing allowed for the initial application. It allows for billing of cast supplies with Q codes. It also provides guidance on billing codes for replacement casts, splints, or strapping and visit codes when unrelated problems are addressed at the same time. Covered ICD-9 diagnosis codes must accompany claims.

Uploaded by

anto_prap
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© © All Rights Reserved
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  • Casts, Splints, and Strapping

ND DEPT OF HUMAN SERVICES

MEDICAL SERVICES DIVISION


SP/ 3-7-02
Retired 3-27-02, 4-1-02; 11-01-13 smr Page 1 of 1


MEDICAID CODING GUIDELINE
Effective: 7-1-02
RETIRED: 11-1-2013

CASTS, SPLINTS, AND STRAPPING

CPT CODES: 29000-29085 & 29305-29450 Casts
29105-29131 & 29505-29515 Splints
29200-29280 & 29520-29590 Strapping
29700-29799 Miscellaneous

INDICATIONS FOR USE:

When a surgical procedure on the musculoskeletal system (20000-28899, 29800-29909) is performed and a
cast, splint, or strapping is applied to the area of the procedure, there is no separate allowance for the initial
application of the cast, splint, or strapping (29000-29550, 29590). However, there can be an additional
allowance for cast supplies (Q4001-Q4051**).

If cast application, splinting or strapping is provided as an initial procedure in which no surgical procedure
is performed (e.g. casting of a sprained ankle or knee), use the appropriate level of E/M code and the
code(s) for cast supplies (Q4001-Q4051**), if appropriate. Codes 29000-29550 and 29590 may not be
used in this situation.

Codes 29000-29550 and 29590 are payable when the cast, splint or strapping is a replacement which is
medically necessary, Cast supplies may be billed separately if appropriate. A visit code on the day of
reapplication could be separately billed and paid only if an unrelated problem was also addressed. In that
situation, the 25 modifier should be added to the visit code and the diagnosis code should identify the
unrelated condition(s).

The allowance for application of a cast, splint or strapping includes removal. Removal by the same physician or
other physician in the same group should not be separately billed.


**Effective July 1
st
, 2002 the new temporary Q codes for cast and splint supplies
(Q4001 Q4051) will be recognized by Medicaid.


COVERED DIAGNOSIS CODES:
Appropriate ICD-9CM code must accompany the claim to support the procedure being performed. (e.g. sprain,
fracture, injury, or other appropriate code)



MC Carrier Manual
Coverage Issues Manual
MC Part B Podiatry Manual
MC Part B News #191, July 2001

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