Minnesota Minnesota

Provider Manual

Provider Manual


Casting & Strapping Services/Supplies

Revised: October 22, 2013

There are no requirements for medical authorization of casting or strapping services provided by physical therapists and occupational therapists in the course of providing rehabilitative services.

Code

Required modifier

Description

29065

GO, GP

Application, cast; shoulder to hand (long arm)

29075

  Elbow to finger (short arm)

29085

  Hand and lower forearm (gauntlet)

29086

  Finger (e.g., contracture)

29105

Application of long arm splint (shoulder to hand)

29125

Application of short arm splint (forearm to hand); static

29126

  Dynamic

29130

Application of finger splint; static

29131

  Dynamic

29200

Strapping; thorax

29240

  Shoulder (e.g., Velpeau)

29260

  Elbow or wrist

29280

  Hand or finger

29345

Application of long leg cast (thigh to toes)

29355

  Walker or ambulatory type

29365

Application of cylinder cast (thigh to ankle)

29405

Application of short leg cast (below knee to toes)

29425

  Walking or ambulatory type

29445

Application of short leg cast (below knee to toes)

29505

Application of long leg splint (thigh to ankle or toes)

29515

Application of short leg splint (calf to foot)

29520

  Strapping; hip

29530

  Knee

29540

  Ankle and/or foot

29550

  Toes

29580

  Unna boot

29581

Application of multi-layer compression system; leg (below knee), including ankle and foot

29582

  Thigh and leg, including ankle and foot, when performed

29583

  Upper arm and forearm

29584

  Upper arm, forearm, hand, and fingers

Casting & Splinting Supplies

There are no requirements for medical authorization of casting or splinting supplies provided by physical therapists and occupational therapists in the course of providing rehabilitative services.

Code

Required modifier

Description

Q4017

GP, GO

Cast supplies; long arm splint, adult (11 years +), plaster

Q4018

Long arm splint, adult (11 years +), fiberglass

Q4019

Long arm splint, pediatric (0-10 years), plaster

Q4020

Long arm splint, pediatric (0-10 years), fiberglass

Q4021

Short arm splint, adult (11 years +), plaster

Q4022

Short arm splint, adult (11 years +), fiberglass

Q4023

Short arm splint, pediatric (0-10 years), plaster

Q4024

Short arm splint, pediatric (0-10 years), fiberglass

Q4041

Long leg splint, adult (11 years +), plaster

Q4042

Long leg splint, adult (11 years +), fiberglass

Q4043

Long leg splint, pediatric (0-10 years), plaster

Q4044

Long leg splint, pediatric (0-10 years), fiberglass

Q4045

Short leg splint, adult (11 years +), plaster

Q4046

Short leg splint, adult (11 years +), fiberglass

Q4047

Short leg splint, pediatric (0-10 years), plaster

Q4048

Short leg splint, pediatric (0-10 years), fiberglass

Q4049

Finger splint, static

Q4051

Splint supplies, misc. (includes thermoplastics, strapping, fasteners, padding and other supplies)

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