Total Contact casting (CPT 29445) would be amended with a 59 as the first modifier (as the payment and distinct separate service). It would then have LT as the secondary modifier. The ICD10 would then need to be the appropriate LT for depth and site.
For the right side the appropriate depth CPT code (e.g. 11042) would be billed and modified with RT modifier again using the correct ICD10 signaling the correct depth and site of that ulcer.
The rationale here is that the cast (29445) is according to the Correct Coding Initiative a component of the 11042 and thus not separately payable. Use of the 59 on the LT and and the site modifier on both claim lines would signal to the carrier that because of the separate site,
there is an exception to the CCI and thus both are payable.
Yes, TCC CPT code 29445 would have a left foot and leg ICD-10-CM diagnosis. Because of bundling concerns, two modifiers would be needed, Modifier 59 and LT appended to the procedure, 29445-LT-59. For the right foot ulcer debridement, it is necessary to show a diagnosis the right foot only, ie: L97.512 Non-pressure chronic ulcer of other part of right foot with fat layer exposed and that diagnosis is only paired with CPT 11042.
Total Contact casting (CPT 29445) would be amended with a 59 as the first modifier (as the payment and distinct separate service). It would then have LT as the secondary modifier. The ICD10 would then need to be the appropriate LT for depth and site.
For the right side the appropriate depth CPT code (e.g. 11042) would be billed and modified with RT modifier again using the correct ICD10 signaling the correct depth and site of that ulcer.
The rationale here is that the cast (29445) is according to the Correct Coding Initiative a component of the 11042 and thus not separately payable. Use of the 59 on the LT and and the site modifier on both claim lines would signal to the carrier that because of the separate site,
there is an exception to the CCI and thus both are payable.
Yes, TCC CPT code 29445 would have a left foot and leg ICD-10-CM diagnosis. Because of bundling concerns, two modifiers would be needed, Modifier 59 and LT appended to the procedure, 29445-LT-59. For the right foot ulcer debridement, it is necessary to show a diagnosis the right foot only, ie: L97.512 Non-pressure chronic ulcer of other part of right foot with fat layer exposed and that diagnosis is only paired with CPT 11042.
Can I get reimbursed for a total contact cast (TCC) on the left foot and leg that is unrelated to the ulcer debridement on right foot?