LCD Reference Article Article

Non-Payment for Prefabricated Splints

A52754

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Draft Article
Draft Articles are works in progress and not necessarily a reflection of the current billing and coding practices. Revisions to codes are carefully and thoroughly reviewed and are not intended to change the original intent of the LCD.
NOT AN LCD REFERENCE ARTICLE
This article is not in direct support of an LCD.

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General Information

Source Article ID
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Article ID
A52754
Original ICD-9 Article ID
Not Applicable
Article Title
Non-Payment for Prefabricated Splints
Article Type
Article
Original Effective Date
10/01/2015
Revision Effective Date
08/31/2018
Revision Ending Date
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Retirement Date
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Article Text

Noridian has noted that providers have been advised by some coding sources to report a splint application code for the application of "off the shelf" or pre-packaged splints. While it may be appropriate to bill for the actual splint, Noridian strongly disagrees with the advice to bill separately for the application of these splints. The application of the pre-packaged splint is a packaged service when performed on the same day as an E/M service or other procedure but, in no case, may this type of splint application be separately billed.

The CPT codes: 29105, 29125, 29126, 29130, 29131, 97760, 97799 are not appropriate to bill in addition to a splint code that has a "fitting" included in the descriptor. Be aware that a large range of "L" codes do include "fitting" in the descriptor

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Revision History Information

Revision History Date Revision History Number Revision History Explanation
08/31/2018 R2

Updated to indicate this article is not an LCD reference article. 

08/31/2018 R1

This final LCA effective 8/31/2018 combines JFB into the JFA LCA so that both JFA and JFB contract numbers will have the same final Medicare Coverage Database (MCD) LCA number A52754.

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Associated Documents

Medicare BPM Ch 15.50.2 SAD Determinations
Medicare BPM Ch 15.50.2
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Public Versions
Updated On Effective Dates Status
11/14/2023 08/31/2018 - N/A Currently in Effect You are here
08/23/2018 08/31/2018 - N/A Superseded View
Some older versions have been archived. Please visit the MCD Archive Site to retrieve them.

Keywords

  • Pre-Fabricated
  • Splints