How To Use CPT Code 29425

CPT 29425 describes the application of a short leg cast, specifically for walking or ambulatory purposes. 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 29425?

CPT 29425 is used to describe the application of a short leg cast that allows the patient to walk or ambulate. This code is specifically used for treating fractures of the lower leg bones (tibia and fibula) or severe ankle sprains. The cast is designed to accommodate a cast shoe or a footplate and rubber heel, which enables the patient to bear weight on the affected leg while providing support and stability.

2. Official Description

The official description of CPT code 29425 is: ‘Application of short leg cast (below knee to toes); walking or ambulatory type.’

3. Procedure

1. The healthcare provider begins by positioning the patient’s 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 to ensure proper circulation and nerve function.
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 over the leg to protect the skin from irritation caused by the cast.
5. Wet casting material, such as plaster of Paris or fiberglass, is then applied in strips over the padding.
6. The underlying stockinette is rolled over the openings in the cast to create smooth edges.
7. The cast is allowed to dry, and its fit is reassessed. If necessary, the cast may be trimmed to accommodate the use of a removable cast shoe or a footplate and rubber heel.

4. Qualifying circumstances

CPT 29425 is used for patients who require a short leg cast for walking or ambulatory purposes. This may include individuals with fractures of the tibia and fibula or severe ankle sprains. The cast is applied by a healthcare provider and is designed to allow the patient to bear weight on the affected leg while providing support and stability.

5. When to use CPT code 29425

CPT code 29425 should be used when a healthcare provider applies a short leg cast specifically for walking or ambulatory purposes. This code is appropriate for patients who require a cast to treat fractures of the lower leg bones or severe ankle sprains. It should not be used for other types of casts or for casts that do not allow the patient to walk or ambulate.

6. Documentation requirements

To support a claim for CPT 29425, the healthcare provider must document the following information:

• Patient’s diagnosis, such as a fracture of the tibia and fibula or a severe ankle sprain
• Details of the cast application, including the use of stockinette, padding, and casting material
• Assessment of the cast’s fit and any necessary adjustments made
• Documentation of any additional services provided, such as the application of a cast shoe or a footplate and rubber heel
• Signature of the healthcare provider who applied the cast

7. Billing guidelines

When billing for CPT 29425, ensure that the cast is specifically for walking or ambulatory purposes. It is important to note that the application of a cast may be included in the primary code for an associated surgical procedure. Replacement of the cast at a later date may be included in the global period of the surgical procedure or may be separately reportable. It is recommended to check with the payer for confirmation and to follow their specific guidelines.

8. Historical information

CPT 29425 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 to a patient with a fractured tibia, allowing them to walk and bear weight on the affected leg.
2. A cast is applied to a patient with a severe ankle sprain, enabling them to ambulate while providing support and stability.
3. A healthcare provider applies a short leg cast to a patient who has undergone surgical repair of a fractured fibula, allowing them to walk during the recovery process.
4. A cast is applied to a patient with a fractured tibia and fibula, providing support and stability while allowing them to bear weight on the affected leg.
5. A healthcare provider applies a short leg cast to a patient with a severe ankle sprain, allowing them to walk and gradually regain mobility.
6. A cast is applied to a patient with a fractured tibia, enabling them to ambulate while the bone heals.
7. A healthcare provider applies a short leg cast to a patient with a fractured fibula, allowing them to walk and bear weight on the affected leg.
8. A cast is applied to a patient with a severe ankle sprain, providing support and stability while allowing them to ambulate.
9. A healthcare provider applies a short leg cast to a patient with a fractured tibia and fibula, enabling them to walk and gradually resume their daily activities.
10. A cast is applied to a patient with a severe ankle sprain, allowing them to bear weight on the affected leg while providing support and stability.