Is Physician Presence Required to Report CPT Code 22310?

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Question:

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

Answer:

This is a great question. 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 must personally apply the brace to report this code. The bracing is an integral part of the work associated with the payment for this CPT code.