Vol. 16 Issue 11
What are the appropriate codes for taping and strapping?
Q:I have a coding question regarding taping and strapping of orthopedic conditions. I do quite a bit of McConnell and kinesiotaping and have been using CPT code 29240 for shoulders. Is that the appropriate code?
A: CPT code 29240 is one possible CPT code to bill this intervention, if your intent is to provide temporary immobilization/fixation due to a fracture, dislocation, sprain or strain. Your documentation must demonstrate the complexity of the patient's need to show the medical necessity of the skilled physical or occupational therapist to assess, fit and instruct.
In addition, it may be appropriate to count the minutes providing the skilled McConnell and kinesiotaping under other CPT codes, such as 97110 (therapeutic exercise) or 97112 (neuromuscular re-education). Under these codes, your intent of the intervention should be to position the joint in its correct position, while providing skilled therapeutic exercises or neuromuscular re-education techniques. Your documentation must be able to clearly support the CPT code you chose and show that the treatment was skilled and medically necessary based on the patient's condition.
Q: I'm an occupational therapist who just started a private practice. I have acquired a Medicare provider number. If a patient is in an HMO, can I still bill Medicare, or do I have to bill the HMO? Also, do I have to apply for a special HMO provider number?
A: If the patient has an HMO instead of Medicare, that's the primary payer. You should bill for the skilled occupational therapy services you provide. I would recommend contacting the specific HMO regarding participation in the plan and inquire about billing for services provided to their clients.
Rick Gawenda, PT, is director of physical medicine and rehabilitation at Detroit Receiving Hospital in Michigan. He's also the president of the American Physical Therapy Association section on health policy and administration. He conducts national seminars on coding and reimbursement, along with other topics. If you have a tough coding issue you can't crack, e-mail firstname.lastname@example.org. To read more coding suggestions, go to www.advanceweb.com/rehab and click on the Coding Clues tool bar.