Will Insurance Cover The Cost of the Carpal Solution?

Customers report that both State Worker’s Compensation and National Health Insurance programs will cover the cost of the Carpal Solution if your physician or hand therapist prescribes it as needed therapy for your Carpal Tunnel Syndrome condition as a Wrist Orthosis. Workers Compensation Codes are different for every state and some Health Insurance codes vary from program to program. Some of the Standardized Codes which are predominate are attached below to aid your physician with a health insurance framework from which they can code their services and the product codes needed for reimbursement of Wrist Orthosis products.

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.

Insurance Codes Often Used by Physicians for Carpal Tunnel
Syndrome Diagnosis, Therapy & Prescriptions

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

HCPCS Code - Miscellaneous Prosthetics/Orthotics Product Section

HCPCS Code L3954 WHF Orthosis spreading hand, upper limb: wrist-hand abduction
HCPCS Code L3946 WHF Orthosis Composite Elastic
HCPCS Code L3911 Wrist hand finger Orthosis elastic, prefabricated
HCPCS Code L3908 Wrist Comfort form all sizes
HCPCS Code L3909 Wrist Orthosis

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

CPT Codes apply to physician, hand therapist and other health professional services reimbursement
HCPCS Codes apply to Product Purchase Reimbursement

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(s)
923.21 Contusion of wrist
923.3 Contusion of finger
927.20 Crushing injury, hand
927.21 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 in 2005.
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.

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

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Will Insurance Cover The Cost of the Carpal Solution?

Insurance Codes Often Used by Physicians for Carpal Tunnel Syndrome Diagnosis, Therapy & Prescriptions

Insurance Codes Often Used by Physicians for Carpal Tunnel
Syndrome Diagnosis, Therapy & Prescriptions