How To Use CPT Code 29700

CPT 29700 describes the removal or modification of a cast covering the body, foot, or hand when it is no longer needed, needs replacement, or has become too tight due to excessive swelling. 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 29700?

CPT 29700 can be used to describe the removal or modification of a cast that covers the body, foot, or hand. This code is used when the cast is no longer needed, needs replacement, or has become too tight due to excessive swelling. The provider uses a cast saw to cut through the cast on both sides, creating front and back halves of the cast. The cast is then separated along the cutting line using a cast spreader, and the padding material is cut close to the skin using blunt edge bandage scissors. The two cast halves are either removed if healing is complete or secured in place with bandage material if bivalving is necessary to reduce swelling.

2. Official Description

The official description of CPT code 29700 is: ‘Removal or bivalving; gauntlet, boot or body cast.’

3. Procedure

1. The provider uses a cast saw to cut through the cast on both sides of the body or extremity, creating front and back halves of the cast.
2. A cast spreader is inserted to separate the cast along the cutting line and break the two halves apart.
3. Blunt edge bandage scissors are used to cut through the padding material close to the skin.
4. If healing is complete or the cast needs replacement, the two cast halves are removed. If bivalving is necessary to reduce swelling, the front and back halves of the cast are secured in place with bandage material.
5. The fit of the cast is assessed and adjustments are made as necessary.

4. Qualifying circumstances

CPT 29700 is used when a cast covering the body, foot, or hand needs to be removed or modified. This may be because the cast is no longer needed, needs replacement, or has become too tight due to excessive swelling. The procedure is typically performed by a provider using a cast saw, cast spreader, and blunt edge bandage scissors. Bivalving, which involves cutting the cast into two parallel sides to relieve swelling or pressure, may be necessary in some cases.

5. When to use CPT code 29700

CPT code 29700 should be used when a cast covering the body, foot, or hand needs to be removed or modified. It is important to note that this code should only be used for casts applied by another provider. If your practice applied the cast, do not report removal or bivalving separately as these services are included in the codes for the application of casts and strapping. Additionally, if the provider performs the procedure bilaterally, you may need to report the code with modifier 50 or with two units, depending on the payer’s preference.

6. Documentation requirements

To support a claim for CPT 29700, the provider must document the following information:

• Reason for the removal or modification of the cast
• Details of the procedure performed, including the use of a cast saw, cast spreader, and blunt edge bandage scissors
• Whether the cast was completely removed or bivalved
• Assessment of the fit of the cast and any adjustments made

7. Billing guidelines

When billing for CPT 29700, ensure that the procedure is performed by a qualified provider and that the cast is removed or modified as necessary. It is important to note that if your practice applied the cast, do not report removal or bivalving separately as these services are included in the codes for the application of casts and strapping. Additionally, if the procedure is performed bilaterally, use modifier 50 or report the code with two units, depending on the payer’s preference. If an evaluation and management (E/M) service is also provided on the same day, use modifier 25 to indicate a separately identifiable E/M service.

8. Historical information

CPT 29700 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A provider removes a gauntlet cast from a patient’s hand after the healing process is complete.
2. A cast covering a patient’s foot becomes too tight due to excessive swelling, and the provider bivalves the cast to relieve the pressure.
3. A body cast is no longer needed for a patient, and the provider removes the cast to allow for mobility.
4. A provider replaces a boot cast on a patient’s foot with a new cast due to wear and tear.
5. A gauntlet cast on a patient’s hand needs to be modified to accommodate changes in swelling, and the provider bivalves the cast to relieve the pressure.
6. A provider removes a body cast from a patient who has fully recovered from their injury.
7. A cast covering a patient’s foot becomes too tight due to excessive swelling, and the provider removes the cast to alleviate discomfort.
8. A provider replaces a gauntlet cast on a patient’s hand with a new cast to ensure proper immobilization.
9. A boot cast on a patient’s foot is no longer needed, and the provider removes the cast to allow for rehabilitation exercises.
10. A provider bivalves a body cast on a patient to reduce swelling and pressure in the affected area.