|
Q4001 |
 |
Casting supplies, body cast adult, with or without head, plaster
| short | Cast sup body cast plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4002 |
|
Cast supplies, body cast adult, with or without head, fiberglass
| short | Cast sup body cast fiberglas |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4003 |
|
Cast supplies, shoulder cast, adult (11 years +), plaster
| short | Cast sup shoulder cast plstr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4004 |
|
Cast supplies, shoulder cast, adult (11 years +), fiberglass
| short | Cast sup shoulder cast fbrgl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4005 |
|
Cast supplies, long arm cast, adult (11 years +), plaster
| short | Cast sup long arm adult plst |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4006 |
|
Cast supplies, long arm cast, adult (11 years +), fiberglass
| short | Cast sup long arm adult fbrg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4007 |
|
Cast supplies, long arm cast, pediatric (0-10 years), plaster
| short | Cast sup long arm ped plster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4008 |
|
Cast supplies, long arm cast, pediatric (0-10 years), fiberglass
| short | Cast sup long arm ped fbrgls |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4009 |
|
Cast supplies, short arm cast, adult (11 years +), plaster
| short | Cast sup sht arm adult plstr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4010 |
|
Cast supplies, short arm cast, adult (11 years +), fiberglass
| short | Cast sup sht arm adult fbrgl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4011 |
|
Cast supplies, short arm cast, pediatric (0-10 years), plaster
| short | Cast sup sht arm ped plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4012 |
|
Cast supplies, short arm cast, pediatric (0-10 years), fiberglass
| short | Cast sup sht arm ped fbrglas |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4013 |
|
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), plaster
| short | Cast sup gauntlet plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4014 |
|
Cast supplies, gauntlet cast (includes lower forearm and hand), adult (11 years +), fiberglass
| short | Cast sup gauntlet fiberglass |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4015 |
|
Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster
| short | Cast sup gauntlet ped plster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4016 |
|
Cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), fiberglass
| short | Cast sup gauntlet ped fbrgls |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4017 |
|
Cast supplies, long arm splint, adult (11 years +), plaster
| short | Cast sup lng arm splint plst |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4018 |
|
Cast supplies, long arm splint, adult (11 years +), fiberglass
| short | Cast sup lng arm splint fbrg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4019 |
|
Cast supplies, long arm splint, pediatric (0-10 years), plaster
| short | Cast sup lng arm splnt ped p |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4020 |
|
Cast supplies, long arm splint, pediatric (0-10 years), fiberglass
| short | Cast sup lng arm splnt ped f |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4021 |
|
Cast supplies, short arm splint, adult (11 years +), plaster
| short | Cast sup sht arm splint plst |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4022 |
|
Cast supplies, short arm splint, adult (11 years +), fiberglass
| short | Cast sup sht arm splint fbrg |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4023 |
|
Cast supplies, short arm splint, pediatric (0-10 years), plaster
| short | Cast sup sht arm splnt ped p |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4024 |
|
Cast supplies, short arm splint, pediatric (0-10 years), fiberglass
| short | Cast sup sht arm splnt ped f |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4025 |
|
Cast supplies, hip spica (one or both legs), adult (11 years +), plaster
| short | Cast sup hip spica plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4026 |
|
Cast supplies, hip spica (one or both legs), adult (11 years +), fiberglass
| short | Cast sup hip spica fiberglas |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4027 |
|
Cast supplies, hip spica (one or both legs), pediatric (0-10 years), plaster
| short | Cast sup hip spica ped plstr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4028 |
|
Cast supplies, hip spica (one or both legs), pediatric (0-10 years), fiberglass
| short | Cast sup hip spica ped fbrgl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4029 |
|
Cast supplies, long leg cast, adult (11 years +), plaster
| short | Cast sup long leg plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4030 |
|
Cast supplies, long leg cast, adult (11 years +), fiberglass
| short | Cast sup long leg fiberglass |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4031 |
|
Cast supplies, long leg cast, pediatric (0-10 years), plaster
| short | Cast sup lng leg ped plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4032 |
|
Cast supplies, long leg cast, pediatric (0-10 years), fiberglass
| short | Cast sup lng leg ped fbrgls |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4033 |
|
Cast supplies, long leg cylinder cast, adult (11 years +), plaster
| short | Cast sup lng leg cylinder pl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4034 |
|
Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass
| short | Cast sup lng leg cylinder fb |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4035 |
|
Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster
| short | Cast sup lngleg cylndr ped p |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4036 |
|
Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass
| short | Cast sup lngleg cylndr ped f |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4037 |
|
Cast supplies, short leg cast, adult (11 years +), plaster
| short | Cast sup shrt leg plaster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: CMS Workgroup | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4038 |
|
Cast supplies, short leg cast, adult (11 years +), fiberglass
| short | Cast sup shrt leg fiberglass |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4039 |
|
Cast supplies, short leg cast, pediatric (0-10 years), plaster
| short | Cast sup shrt leg ped plster |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4040 |
|
Cast supplies, short leg cast, pediatric (0-10 years), fiberglass
| short | Cast sup shrt leg ped fbrgls |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4041 |
|
Cast supplies, long leg splint, adult (11 years +), plaster
| short | Cast sup lng leg splnt plstr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4042 |
|
Cast supplies, long leg splint, adult (11 years +), fiberglass
| short | Cast sup lng leg splnt fbrgl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4043 |
|
Cast supplies, long leg splint, pediatric (0-10 years), plaster
| short | Cast sup lng leg splnt ped p |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4044 |
|
Cast supplies, long leg splint, pediatric (0-10 years), fiberglass
| short | Cast sup lng leg splnt ped f |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4045 |
|
Cast supplies, short leg splint, adult (11 years +), plaster
| short | Cast sup sht leg splnt plstr |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4046 |
|
Cast supplies, short leg splint, adult (11 years +), fiberglass
| short | Cast sup sht leg splnt fbrgl |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4047 |
|
Cast supplies, short leg splint, pediatric (0-10 years), plaster
| short | Cast sup sht leg splnt ped p |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4048 |
|
Cast supplies, short leg splint, pediatric (0-10 years), fiberglass
| short | Cast sup sht leg splnt ped f |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4049 |
|
Finger splint, static
| short | Finger splint, static |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| DME | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy |
|
|
|
|
Q4050 |
|
Cast supplies, for unlisted types and materials of casts
| short | Cast supplies unlisted |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|
|
Q4051 |
|
Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding and other supplies)
| short | Splint supplies misc |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
|
|
|