How To Use CPT Code 29445

CPT 29445 describes the application of a rigid total contact leg cast by a healthcare provider. 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 29445?

CPT 29445 can be used to describe the application of a rigid total contact leg cast by a healthcare provider. This code is used when the provider applies a short leg walking cast, known as a total contact cast (TCC), to treat diabetic ulcers. The TCC covers the lower leg, ankle, and foot and is designed to fit a removable cast shoe that allows the patient to walk.

2. Official Description

The official description of CPT code 29445 is: ‘Application of rigid total contact leg cast.’

3. Procedure

1. The healthcare provider measures the ulcer and applies tubular stockinette from the knee to the toes.
2. Cotton or synthetic padding is applied to pressure points.
3. Molded elasticized plaster is applied as the first casting layer, followed by layers of standard plaster.
4. The entire cast is covered with fiberglass casting tape.
5. If a removable rigid cast shoe is used, it is applied over the cast. Alternatively, a footplate and rubber walking heel can be incorporated into the cast.
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.
8. If a cast shoe is used, the strapping is adjusted for proper fit.

4. Qualifying circumstances

CPT 29445 is used for the treatment of diabetic ulcers. It is specifically for the application of a rigid total contact leg cast. Diabetic ulcers are open sores that occur frequently on the feet and lower legs of individuals with diabetes due to complications from vascular and nerve damage. The cast is applied by a healthcare provider to promote healing and protect the ulcer from further damage.

5. When to use CPT code 29445

CPT code 29445 should be used when a healthcare provider applies a rigid total contact leg cast to treat diabetic ulcers. It is important to ensure that the cast is applied according to the specific requirements of the code. If a different type of cast or treatment is used, a different CPT code should be reported.

6. Documentation requirements

To support a claim for CPT 29445, the healthcare provider must document the following information:

• Measurement of the ulcer
• Application of tubular stockinette
• Use of cotton or synthetic padding
• Application of molded elasticized plaster and standard plaster
• Covering of the cast with fiberglass casting tape
• Application of a removable rigid cast shoe or incorporation of a footplate and rubber walking heel
• Rolling of the underlying stockinette over the cast openings
• Assessment of the cast’s fit and any necessary trimming
• Adjustment of the strapping for proper fit
• Signature of the healthcare provider

7. Billing guidelines

When billing for CPT 29445, ensure that the cast is applied according to the specific requirements of the code. It is important to accurately document the procedure and provide the necessary supporting documentation. CPT code 29445 should not be reported with other codes unless additional procedures or services are performed that are separately reportable.

8. Historical information

CPT 29445 was added to the Current Procedural Terminology system on January 1, 1995. There have been no updates to the code since its addition.

9. Examples

1. A healthcare provider applies a rigid total contact leg cast to treat a diabetic ulcer on a patient’s lower leg.
2. A podiatrist applies a total contact cast to a patient’s foot and ankle to promote healing of a diabetic ulcer.
3. An orthopedic surgeon applies a rigid total contact leg cast to immobilize a fracture in a patient’s lower leg.
4. A wound care specialist applies a total contact cast to protect a diabetic ulcer on a patient’s foot and facilitate healing.
5. A nurse practitioner applies a rigid total contact leg cast to treat a diabetic ulcer on a patient’s ankle.
6. An orthopedic technician applies a total contact cast to a patient’s lower leg to stabilize a fracture.
7. A physician assistant applies a rigid total contact leg cast to a patient’s foot and ankle to promote healing of a diabetic ulcer.
8. A wound care nurse applies a total contact cast to protect a diabetic ulcer on a patient’s lower leg.
9. An orthopedic surgeon applies a rigid total contact leg cast to immobilize a fracture in a patient’s ankle.
10. A podiatrist applies a total contact cast to a patient’s foot and lower leg to promote healing of a diabetic ulcer.