Billing for Splint Application: Medicare & Private Insurance Guidelines

The application of a splint in a physician's office is a common treatment for a patient who has a broken finger, arm or leg. Many practitioners and medical billers want to know if they can bill Medicare and private insurances for the procedure. If no other treatment was performed, a cast application that is provided during an initial treatment is billable.

Things You'll Need

• CPT code book
• HCFA 1500 forms

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Instructions

• 1

  Identify the Current Procedural Terminology (CPT) code for the evaluation and management (E&M) encounter.

• 2

  Enter the E&M code into box 24d on line one of the Heath Insurance Claim Form (HCFA 1500).

• 3

  Identify the CPT code for the application of the splint.

• 4

  Enter the E&M code into box 24d on line two of the HCFA 1500 and complete the remainder of the HCFA 1500 with the patient's information.

• 5

  Submit the claim to the patient's insurance company either electronically or on paper.