January 18, 2018
We are having a discussion in our office about how to report the application of off-the-shelf braces that are dispensed in our office. The nurses are adding splint application codes to the encounter forms, such as 29125 and 29515, but the coder only wants to report the HCPCS supply code. Which method is correct?
The coder is correct in this case. The splint application CPT codes are used when a physician or provider such as a PT or OT creates a splint from “raw materials”, such as plaster, fiberglass, padding, and ace bandages. Examples include sugar tong splints and thumb spica splints, among others. The HCPCS codes used for reporting off-the-shelf braces, also called prefabricated orthotics, include the fitting of the item, so a splint application code would not be separately reportable. Even orthotics that do require custom fitting would not support separate reporting of a splint application, as the HCPCS definitions for those codes include the language “includes fitting and adjustment.”
*This response is based on the best information available as of 01/18/18.