Splinting and Strapping Policy – What You Need to Know

June 8, 2020

Correctly coding casts, splints, and strapping can be confusing. Much of the confusion is related to what type of materials are classified as casts, splints, or strapping; whether the CPT application codes should be assigned, and whether the performed is included in the E/M codes and documentation.

In order to be compliant with CPT/AMA and CMS (Medicare) guidelines, Zotec has updated the splint application billing policy for its physician clients. Per CPT guidelines, the codes for casts, strapping and splint application are included in the fracture/dislocation care codes and cannot be billed separately when fracture or dislocation care codes are billed. Below are three measures physicians should follow.

1. For all payors, physicians may bill for strapping application only if it is documented in the chart that they personally applied it.
2. For Medicare charts, physicians may bill for a splint application only if it is documented in the chart that they personally applied it.
3. For non-Medicare charts, physicians may bill for a splint application in one of two ways:

• Document in the chart that they personally applied it; or
• Document in the chart that the physician provided direct supervision of the splint application. Direct supervision means that a physician was physically present during the application.*

For T-System users, T-System is currently working on an update that will include a check-box for “direct supervision” on the charts that have a splinting section. It is not yet available; in the interim (and for groups who do not utilize the T-System) it is acceptable document a note on the chart to indicate that direct supervision was provided, such as “I directly supervised the splint application”, again, with the understanding that direct supervision in this context means that you were physically present in the room when the splint was applied.

In order to achieve maximum reimbursement, physicians should adhere to these guidelines for the Splint and Strapping Application.

By: Stacie Norris, MBA, CPC, CCS-P, Director of Coding Quality Assurance

Learn more about Zotec Partners here.