“Can CPT code 29580 (strapping – Unna’s boot) be used for ICD code M65.871(2) in lieu of CPT code 29540? If not, what is the best ICD 10 code for CPT 29580?”
CPT code 29580 is defined as: Strapping; Unna boot
CPT code 29540 is defined as: Strapping; ankle and/or foot
What are the indications for CPT code 29580?
- Appropriate when compression and/or support is medically necessary
- Acute injury or illness requiring immediate immobilization/compression for swelling/stability
- Injury to the foot and/or ankle
- Acute edema requiring control and/or compression
- Ulcerations and venous insufficiency
ICD-10-CM codes M65.871 and M65.872 are defined as: Other synovitis and tenosynovitis, right ankle and foot and Other synovitis and tensosynovitis, left ankle and foot, respectively.
It would be so helpful if the Medicare Administrative Carriers had an LCD for “Strapping.” It would make life so much easier. First Coast Service Options, the Medicare Administrative Carrier for Florida did have such an LCD which was unfortunately retired in July,2020: Local Coverage Determination (LCD): Strapping (L34023). The associated article, Local Coverage Article: Billing and Coding: Strapping (A57129) was also retired in July,2020. Nevertheless, when the article is accessed, M65.871 and M65.872 are definitely covered diagnoses for CPT code 29540, but they are NOT covered diagnoses for CPT code 29580. That is not to say that they would not be covered diagnoses for CPT code 29580 anywhere else in the country, but in all likelihood, probably not.
I believe that CPT code 29580 is not reimbursable, unless there is an acute injury to the foot, ankle, or lower leg where edema is present and immediate compression/immobilization is needed, which is documented as such in the retired First Coast Service Options article. An Unna boot has been referred to as a “soft cast.” Need I say more?
This is my opinion.
Dr. Michael G. Warshaw
DPM, CPC
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