Strapping; shoulder (see also 29823, 29824)
Audit Defense & Denial Intelligence
Research-based denial patterns from OrbDoc Bill Analyzer
1. Strapping/taping billed same day as E&M without modifier or separate medical necessity
Common29260 (strapping elbow or wrist) bundled into E&M visit when strapping is only service or minor component. If strapping performed for specific injury and E&M separately necessary, modifier -25 required on E&M. Denied when strapping included as part of E&M evaluation/management.
Common Causes
- • Wrist strain, strapping applied, E&M billed without modifier - bundled
- • Strapping for injury evaluation - included in E&M, not separately billable
- • No documentation justifying separate E&M beyond strapping application
Resolution Strategy
Determine if E&M separately necessary: If patient presents with wrist sprain and only service is examination and strapping, bill E&M only (strapping bundled). If patient also has separate medical problem requiring E&M beyond strapping, add modifier -25 to E&M and bill 29260 separately with documentation: 'Chief complaint 1: Wrist sprain, strapping applied. Chief complaint 2: Hypertension follow-up, medication adjustment...' If only strapping for injury, bill E&M code appropriate to complexity - strapping included. Cannot appeal bundling without documented separate medical necessity.
Relative Value Units (RVUs)
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Clinical Information
When to Use
For therapeutic strapping of shoulder for stability, pain relief, or support in rotator cuff injury, subluxation, or strain
Common Scenarios
Documentation Requirements
- Shoulder condition or injury
- Strapping pattern/technique used
- Medical necessity for stabilization
- Patient self-removal instructions
- Duration expected for treatment
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes tape/strap supplies
- Does not include injection therapy
- May combine with 29823-29824 arthroscopic procedures
Exclusions
- Casting uses different codes
- Surgical repair uses different codes
- Injectable therapy coded separately
Coding Notes
Clinical scenarios
- Shoulder condition or injury
- Strapping pattern/technique used
- Medical necessity for stabilization
- Shoulder condition or injury
- Strapping pattern/technique used
- Medical necessity for stabilization
- Shoulder condition or injury
- Strapping pattern/technique used
- Medical necessity for stabilization
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Ask a QuestionFrequently Asked Questions
CPT 29260 is the billing code for "Strapping; shoulder (see also 29823, 29824)". For therapeutic strapping of shoulder for stability, pain relief, or support in rotator cuff injury, subluxation, or strain
Medicare pays approximately $28.14 for CPT 29260 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.
CPT 29260 has a total RVU of 1.82, broken down as: Work RVU 0.82, Practice Expense RVU 0.92, and Malpractice RVU 0.08. RVUs (Relative Value Units) determine Medicare reimbursement rates.
The most common denial reason for CPT 29260 is "Strapping/taping billed same day as E&M without modifier or separate medical necessity". 29260 (strapping elbow or wrist) bundled into E&M visit when strapping is only service or minor component. If strapping performed for specific injury and E&M separately necessary, modifier -25 required on E&M. Denied when strapping included as part of E&M evaluation/management. Common causes include: Wrist strain, strapping applied, E&M billed without modifier - bundled; Strapping for injury evaluation - included in E&M, not separately billable. Appeal success rate is approximately 10-30%.
Key documentation requirements for CPT 29260 include: Shoulder condition or injury; Strapping pattern/technique used; Medical necessity for stabilization; Patient self-removal instructions. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 29260: Includes tape/strap supplies. Does not include injection therapy Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 29260 include: 59 (Distinct procedural service), 76 (Repeat procedure by same physician). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 29260 is 15-20 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.