How To Use CPT Code 29085

CPT 29085 describes the application of a cast encasing the hand and lower forearm, known as a gauntlet cast. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29085?

CPT 29085 can be used to describe the application of a gauntlet cast, which is a cast that encases the hand and lower forearm. This procedure is typically performed to treat fractures of the wrist and hand or to immobilize the area after a surgical procedure.

2. Official Description

The official description of CPT code 29085 is: ‘Application, cast; hand and lower forearm (gauntlet).’ This code is used when a healthcare provider applies a cast that covers the hand and lower forearm, including the thumb.

3. Procedure

1. Before applying the cast, the healthcare provider performs a complete neurovascular exam of the affected region to assess the patient’s condition.
2. The provider covers the hand and lower forearm with stockinette, a loose knit fabric, to protect the skin.
3. Cotton or synthetic padding is applied over the stockinette to provide additional protection and prevent irritation.
4. The provider then applies wet casting material, such as plaster of Paris or fiberglass, in strips over the padding.
5. The underlying stockinette is rolled over the openings in the cast to smooth out the edges.
6. The cast is allowed to dry, and the provider reassesses its fit, making any necessary adjustments by trimming it if needed.

4. Qualifying circumstances

CPT 29085 is typically performed when a patient has a fracture of the wrist or hand that requires immobilization or when a gauntlet cast is needed after a surgical procedure. The procedure is performed by a healthcare provider who has the necessary expertise in applying casts.

5. When to use CPT code 29085

CPT code 29085 should be used when a healthcare provider applies a gauntlet cast to immobilize the hand and lower forearm. It is important to note that this code should not be reported if the cast application is included in the primary code for an associated surgical procedure. Additionally, if the cast needs to be replaced at a later date, it may be included in the global period of the surgical procedure or reported separately, depending on the payer’s guidelines.

6. Documentation requirements

To support a claim for CPT 29085, the healthcare provider must document the following information:

• A complete neurovascular exam of the affected region
• Use of stockinette and padding to protect the skin
• Type of casting material used
• Date of the cast application
• Assessment of the cast’s fit and any adjustments made
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 29085, ensure that the procedure is performed by a healthcare provider with the necessary expertise in applying casts. It is important to follow the payer’s guidelines regarding reporting this code with other services or procedures. If an evaluation and management (E/M) service is also provided on the same day, the appropriate E/M code should be reported with modifier 25 to indicate that it is a separately identifiable service.

8. Historical information

CPT 29085 was added to the Current Procedural Terminology system on January 1, 1990. The code’s description was changed on January 1, 2002 to specify the application of a gauntlet cast.

9. Examples

1. A patient with a fractured wrist undergoes the application of a gauntlet cast to immobilize the hand and lower forearm.
2. After a surgical procedure on the hand, a gauntlet cast is applied to provide post-operative immobilization.
3. A healthcare provider applies a gauntlet cast to treat a fracture of the thumb and immobilize the hand and lower forearm.
4. Following a surgical procedure on the wrist, a gauntlet cast is applied to support the healing process and prevent movement.
5. A patient with a hand injury receives a gauntlet cast to protect the affected area and promote proper healing.
6. After a surgical procedure on the forearm, a gauntlet cast is applied to provide stability and support during the recovery period.
7. A healthcare provider applies a gauntlet cast to immobilize the hand and lower forearm after a fracture of the fingers.
8. Following a surgical procedure on the hand and wrist, a gauntlet cast is applied to protect the surgical site and aid in the healing process.
9. A patient with a wrist fracture receives a gauntlet cast to prevent further injury and promote proper alignment of the bones.
10. After a surgical procedure on the hand, a gauntlet cast is applied to provide post-operative support and immobilization.