How To Use CPT Code 29405

CPT 29405 describes the application of a short leg cast (below knee to toes) for the treatment of a fracture in the lower leg or a severe ankle sprain. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 29405?

CPT 29405 can be used to describe the application of a short leg cast (below knee to toes) for the treatment of a fracture in the lower leg or a severe ankle sprain. This code is used when a healthcare provider applies a cast to immobilize the lower leg, specifically the tibia and fibula, or to provide support for a severe ankle sprain. The cast extends from just below the knee down over the foot, leaving the toes free.

2. Official Description

The official description of CPT code 29405 is: ‘Application of short leg cast (below knee to toes).’ There are no additional notes or modifiers specified for this code.

3. Procedure

1. The healthcare provider positions the leg with the foot in a neutral position, as if standing.
2. A complete neurovascular exam of the affected region is performed before applying the cast.
3. The lower leg is covered with stockinette, a loose knit fabric, from below the ankle to above the toes.
4. Cotton or synthetic padding is applied to protect the skin from irritation.
5. Wet casting material, such as plaster of Paris or fiberglass, is applied in strips over the padding.
6. The underlying stockinette is rolled over the openings in the cast to smooth out the edges.
7. The cast is allowed to dry, and its fit is reassessed. Trimming may be done if necessary.

4. Qualifying circumstances

CPT 29405 is used when a patient has a fracture in one or both bones of the lower leg (tibia and fibula) or a severe ankle sprain that requires immobilization or support with a short leg cast. The procedure is performed by a healthcare provider who has the necessary expertise in applying casts. The cast is applied to provide stability and promote healing of the affected area.

5. When to use CPT code 29405

CPT code 29405 should be used when a healthcare provider applies a short leg cast (below knee to toes) for the treatment of a fracture in the lower leg or a severe ankle sprain. It is important to ensure that the procedure meets the specific criteria outlined in the code description.

6. Documentation requirements

To support a claim for CPT 29405, the healthcare provider must document the following information:

• Patient’s diagnosis, indicating the presence of a fracture in the lower leg or a severe ankle sprain
• Details of the procedure, including the application of the short leg cast
• Date of the procedure
• Any additional relevant information, such as the need for a neurovascular exam or any complications encountered
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 29405, ensure that the procedure meets the specific criteria outlined in the code description. It is important to follow the guidelines provided by the payer regarding the reporting of this code. If the cast application is included in the primary code for an associated surgical procedure, it may not be separately reportable. Replacement of the cast at a later date may be included in the global period of the surgical procedure or may be separately reportable, depending on the payer’s policies.

8. Historical information

CPT 29405 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider applies a short leg cast (below knee to toes) to immobilize a fractured tibia in a patient.
2. A patient with a severe ankle sprain receives a short leg cast (below knee to toes) for support and stabilization.
3. A healthcare provider applies a short leg cast (below knee to toes) to treat a fracture in the fibula of a patient’s lower leg.
4. A patient with a severe ankle sprain undergoes the application of a short leg cast (below knee to toes) to aid in the healing process.
5. A healthcare provider applies a short leg cast (below knee to toes) to provide stability and support for a patient with a fractured tibia and fibula.
6. A patient with a severe ankle sprain receives a short leg cast (below knee to toes) to prevent further injury and promote healing.
7. A healthcare provider applies a short leg cast (below knee to toes) to immobilize a fractured tibia and fibula in a patient’s lower leg.
8. A patient with a severe ankle sprain undergoes the application of a short leg cast (below knee to toes) to reduce pain and swelling.
9. A healthcare provider applies a short leg cast (below knee to toes) to provide stability and support for a patient with a fractured tibia.
10. A patient with a severe ankle sprain receives a short leg cast (below knee to toes) to aid in the recovery process and prevent further damage.