The Carpal Tunnel Solution
 

Insurance Codes Often Used by Physicians

for Carpal Tunnel Syndrome Diagnosis, Therapy & Prescriptions

CPT Codes apply to physician, and other health professional services reimbursement. HCPCS Codes apply to Product Purchase Reimbursement or Coverage.

International Classification of Disease Coding: 354.0 Carpal Tunnel Syndrome

HCPCS Code - Miscellaneous Prosthetics/Orthotics Product Section

HCPCS Code L3954 WHF Orthosis spreading hand, upper limb: wrist-hand abduction.

Orthosis Devices must be prescribed by a physician to qualify for insurance reimbursement.

Orthosis - or·tho·sis n. pl. or·tho·ses Definition:
An external orthopedic appliance that prevents or assists the movement of the spine or limbs, Orthotic, The American Heritage® Stedman's Medical Dictionary Copyright © 2002.

Neuromuscular Re-education CPT code 97112 ICD Code 354.0 Carpal Tunnel Syndrome.

a. The patient having the loss of deep tendon reflexes and vibration sense accompanied by paresthesia, burning, or diffuse pain of the hand and fingers or feet and lower legs.
b. The patient having nerve palsy, such as radial nerve injury causing wrist drop, carpal tunnel syndrome, etc.

Therapeutic Procedures

         CPT Code 97001 Physical Evaluation

         CPT Code 97504 Orthotic Training

         CPT Code 97140 Manual Therapy

         CPT Code 97535 Self Care Home Management Training

         CPT Code 97537 Work Reintegration Training

         CPT Code 97750 Physical Performance Test or Measurement

         CPT Code 97002 Re-evaluation

         CPT Codes 97032 - 97039
         Application of a modality to one or more areas requiring direct patient contact

         CPT Codes 97010 - 97028
         Application of a modality to one or more areas not requiring direct patient contact

         CPT Codes 97799 unlisted physical medicine/rehab service

         CPT Codes 97139 unlisted therapeutic procedure

Joint Mobilization CPT code 97140 Serial bandaging

Application of short Arm splint (forearm to hand) - Indication for the forearm, wrist and or hand in the treatment of fractures, dislocations, sprains/strains, tendonitis, post-op reconstruction, contractures or other deformities involving soft tissue.

CPT code 29126 dynamic        CPT code 29125 static

Common Tapping and Strapping - Indication when there is treatment of contusions, dislocations, fractures, sprains, strains, post-op conditions, contractures, or other deformities involving soft tissues.

CPT Code 29280 Hand and Finger (can also be applied for HCPCS Code)

CPT Code 29260 Wrist and Elbow (can also be applied for HCPCS Code)

Misc Code: 99070 For supplies and material provided during office visit

HCPCS Code A4450 Tape non-waterproof

CTS Related ICD Codes for descriptive purposes - 354.0 Carpal Tunnel Syndrome
(International Classification of Disease)

Nerve / Sensation / Pain Codes

354.0 Carpal Tunnel Syndrome
719.44 Pain in joint, hand
719.43 Wrist Pain
729.5 Pain in limb
354.5 Mononeuritis multiplex - Combinations of single conditions classifiable to 354 o 355
354.8 Other Mononeuritis of upper limb Inflammation of a single nerve
354.9 Mononeuritis of upper limb, unspecified Inflammation of a single nerve
719.41 Shoulder Pain

Miscellaneous Soft Tissue Injury Codes

923.20 Contusion of hand
923.21 Contusion of Wrist
923.3 Contusion of finger
927.2 Crushing injury, hand
927.23 Crushing injury, wrist

Wrist Pain - Denervation Codes

906.3 Late effect of contusion (nonspecific)
905.7 Late effect of sprain/strain (nonspecific)
719.43 Pain in joint, forearm

References:
Current Procedural Terminology (CPT) manual published by AMA in 2005.
Healthcare Common Procedure Coding Systems (HCPCS) published by Medical Management Institute.
The American Heritage® Stedman's Medical Dictionary Copyright © 2002.
International Classification of Disease published by The Center for Disease Control and Prevention (CDC) US Department of Health and Human Services - National Center for Health Statistics Hyattsville, MD.

These codes are offered as a framework for understanding the insurance coding procedures for the diagnosis, treatment and prescription of medical products for hand pain, wrist pain, nerve disorders in the hand and wrist, hand numbness, tingling in fingers, tingling thumb, numb fingers, numb thumb, and other generally recognized symptoms of carpal tunnel syndrome.

Orthosis Devices must be prescribed under a licensed Physician's judgment with the appropriate insurance code to qualify for insurance reimbursement.