How To Use CPT Code 29581

CPT 29581 refers to the application of a multi-layer compression system on the leg, including the ankle and foot, and this article will cover its description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples.

1. What is CPT 29581?

CPT 29581 is a medical billing code used to describe the application of a multi-layer compression system on a patient’s leg, specifically below the knee, including the ankle and foot. This procedure is typically performed to treat venous stasis ulcers and venous insufficiency, which is the failure of blood veins immediately below the skin. The multi-layer compression system helps control blood flow in the extremity and reduces swelling, providing a stable environment for ulcer healing.

2. 29581 CPT code description

The official description of CPT code 29581 is: “Application of multi-layer compression system; leg (below knee), including ankle and foot.”

3. Procedure

The 29581 procedure involves the following steps:

1. The provider ensures the lower leg and foot are clean and dry.
2. A cotton bandage is applied in a spiral fashion from just below the knee down to the top of the toes.
3. A second layer is applied using a crepe bandage, again in a spiral fashion.
4. A third layer is applied using a compression bandage that is applied with some stretch, also in a spiral fashion.
5. The provider assesses the fit and pressure as they apply the bandage.
6. The bandage is changed once or twice a week.

4. Qualifying circumstances

Patients who are eligible to receive CPT code 29581 services are those diagnosed with venous stasis ulcers or venous insufficiency. These conditions often result from poor blood circulation in the lower extremities, leading to the formation of ulcers and other complications. The multi-layer compression system is an effective treatment for these conditions, as it helps control blood flow and reduce swelling, promoting ulcer healing.

5. When to use CPT code 29581

It is appropriate to bill the 29581 CPT code when a healthcare provider applies a multi-layer compression system to a patient’s leg, ankle, and foot to treat venous stasis ulcers or venous insufficiency. The code should be used for each application of the compression system, and the provider should document the frequency of bandage changes as part of the patient’s medical record.

6. Documentation requirements

To support a claim for CPT 29581, the following information should be documented in the patient’s medical record:

• Diagnosis of venous stasis ulcers or venous insufficiency
• Indication for the use of a multi-layer compression system
• Details of the procedure, including the materials used and the application technique
• Frequency of bandage changes
• Progress of ulcer healing and any complications or adverse reactions

7. Billing guidelines

When billing for CPT code 29581, it is important to follow the appropriate guidelines and rules. Do not report 29581 in conjunction with 29540 (Strapping, ankle and or foot) or 29580 (Strapping, Unna boot) for the same extremity. Use the appropriate modifier to indicate the target leg, such as RT (Right side) or LT (Left side). For a bilateral procedure, apply modifier 50 (Bilateral procedure).

8. Historical information

CPT 29581 was added to the Current Procedural Terminology system on January 1, 2010. The code was changed on January 1, 2012, with the previous descriptor being “Application of multi-layer venous wound compression system, below knee.”

9. Similar codes to CPT 29581

Five similar codes to CPT 29581 and how they differentiate from it are:

• CPT 29580: Involves the application of an Unna boot, which is a specific type of compression dressing used for venous ulcers.
• CPT 29540: Refers to the strapping of the ankle and/or foot, which is a different technique than the multi-layer compression system.
• CPT 29530: Involves the strapping of the knee, which targets a different area of the leg than CPT 29581.
• CPT 29550: Refers to the strapping of toes, which is a more specific and localized procedure than the multi-layer compression system.
• CPT 29520: Involves the strapping of the hip, which is a different area of the body than the leg, ankle, and foot targeted by CPT 29581.

10. Examples

Here are 10 detailed examples of CPT code 29581 procedures:

1. A patient with a venous stasis ulcer on the medial aspect of their lower leg receives a multi-layer compression system application.
2. A patient with venous insufficiency and recurrent swelling in their lower leg undergoes the application of a multi-layer compression system to control edema.
3. A patient with a history of deep vein thrombosis and post-thrombotic syndrome receives a multi-layer compression system to manage their symptoms.
4. A patient with a non-healing venous ulcer on their ankle is treated with a multi-layer compression system to promote wound healing.
5. A patient with chronic venous insufficiency and skin changes on their lower leg undergoes the application of a multi-layer compression system to manage their condition.
6. A patient with a venous stasis ulcer on the lateral aspect of their lower leg receives a multi-layer compression system application.
7. A patient with a history of varicose veins and recurrent leg swelling is treated with a multi-layer compression system to control their symptoms.
8. A patient with a non-healing venous ulcer on their foot undergoes the application of a multi-layer compression system to promote wound healing.
9. A patient with a venous stasis ulcer on the posterior aspect of their lower leg receives a multi-layer compression system application.
10. A patient with a history of venous insufficiency and recurrent leg ulcers undergoes the application of a multi-layer compression system to manage their condition.