Is Physician Presence Required to Report CPT Code 22310?

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July 24, 2014

Question:

Our neurosurgeon saw a patient in the office and diagnosed the patient as having a vertebral body fracture. The neurosurgeon ordered a brace to be applied, which was done when she was not present in the office. She wants us to report CPT code 22310, but we are saying that in order to bill this, the surgeon must be present for the application of the brace. Is this correct, or can she report 22310 just for diagnosing the fracture and ordering the brace?

Answer:

CPT code 22310 reads “Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracing.” The surgeon must be present for the application or personally apply the brace to report this code.