MedEfficiency, Inc.
Toll Free: (866) 357-7755
Phone: (303) 321-7755
Fax: (303) 321-6081
sales@medefficiency.com
5161 Ward Road, Unit 7
Wheat Ridge, CO 80033
Reimbursement
Reimbursement Hotline: 877.706.2411
Physician Office and Hospital Outpatient Setting - Coding
APPLICATION CODING - Physician Office and Hospital Outpatient Department
| CPT | Code Descriptor |
| 29445 |
Application of rigid total contact leg cast |
SUPPLY CODING - Physician Office ONLY
| HCPCS | Code Descriptor |
| Q4038 | Cast Supplies, short leg cast, adult [11 years +], fiberglass |
Hospital Outpatient Setting - Reimbursement
MEDICARE FACILITY REIMBURSEMENT* - Hospital Outpatient
| CPT 29445 | $179.55 - Links to APC code 0426 (National Average) |
| Q4038 | Not separately payable by Medicare, but may be paid by other insurances |
MEDICARE PHYSICIAN REIMBURSEMENT* - Hospital Outpatient
| CPT 29445 | $108.93 (National Average) |
| Q4038 | Not separately payable; the physician did not incur the cost for the supply |
Physician Office Setting- Reimbursement
MEDICARE PHYSICIAN REIMBURSEMENT - Physician Office
| CPT 29445 | $136.82 (National Average) |
| Q4038 | $38.90 per roll of fiberglass applied |
ICD-9-CM DIAGNOSIS CODING:
Diagnoses codes are determined by the provider, as applicable.
*Amount represents Medicare's national average fee schedule for these services. Medicare payment is based on 80 percent of the fee schedule amount. The patient (or secondary insurer) is responsible for the remaining 20 percent. Each insurer's specific coverage policies apply, if available.