Summary & Overview

CPT 29044: Application of Body Cast, Shoulder to Hips and Down One Thigh

CPT code 29044 represents the application of a body cast extending from the shoulders to the hips and down one thigh, a procedure commonly used in orthopedic settings to immobilize and support patients with significant fractures or injuries. This code is nationally recognized and plays a critical role in the management of complex musculoskeletal trauma, ensuring proper healing and patient safety. The procedure is typically performed in an office environment and is covered by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare.

This publication provides a comprehensive overview of 29044, including payer coverage, clinical context, and related policy updates. Readers will gain insight into the benchmarks for reimbursement, the typical clinical scenarios where this code is utilized, and the importance of accurate coding for orthopedic and trauma care. The summary also highlights associated taxonomies and relevant ICD-10 diagnoses, offering a clear understanding of the procedure's place within the broader landscape of orthopedic services. By examining payer policies and clinical guidelines, the article equips healthcare professionals and administrators with the information needed to navigate billing and compliance for this specialized service.

AetnaBlue Cross Blue ShieldCigna HealthMedicareUnitedHealthcareCPT 29044orthopedic surgerybody cast applicationcast and strappingmusculoskeletal traumaoffice proceduresclinical benchmarkspolicy updatesICD-10 fracture codesmedical billing

CPT Code Overview

CPT code 29044 describes the application of a body cast that extends from the shoulders to the hips and down one thigh. This procedure is classified under Surgery – Application of Casts and Strapping and is typically performed in an office setting (POS 11). The cast is used to immobilize the trunk and one lower limb, providing stability for fractures or other injuries requiring extensive immobilization. This service is essential in orthopedic care for patients with complex injuries that necessitate comprehensive support and protection during the healing process.

Clinical & Coding Specifications

Clinical Context

A patient presents to the office with a significant fracture involving the lower extremity, such as a femur or pelvis, or a complex injury requiring immobilization from the shoulders to the hips and down one thigh. The provider, typically an orthopaedic surgeon or trauma specialist, evaluates the injury and determines that a body cast extending from the shoulders to the hips and down one thigh is necessary for optimal stabilization and healing. The cast is applied in the office setting, ensuring proper alignment and immobilization. The procedure is documented under CPT code 29044.

Coding Specifications

Modifiers:
- LT - Left side: Used when the cast is applied to the left thigh.
- RT - Right side: Used when the cast is applied to the right thigh.
Associated Provider Taxonomies:

Taxonomy Code Specialty Name
207X00000X

Taxonomy Code	Specialty Name
`207X00000X`

National Reimbursement Benchmarks

For CPT code 29044, the national mean rate for Medicare is $345.98, while the average commercial benchmark (BUCA) is $306.84. This places Medicare above the commercial average, with UnitedHealth Group showing the highest mean rate among all payers at $424.62.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Aetna has the tightest range at $91.83, indicating less variability in rates, while UnitedHealth Group exhibits the widest spread at $244.00, reflecting greater variability in reimbursement. Cigna and BCBS also show substantial dispersion, with ranges of $209.00 and $126.25, respectively.

The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.

National Mean Rates by Payer for CPT Code `29044`

Related Diagnoses

S52.501A - Unspecified fracture of the lower end of right radius, initial encounter for closed fracture
- Relevant for patients with a right radius fracture requiring immobilization, though this is an upper extremity injury.
S52.502A - Unspecified fracture of the lower end of left radius, initial encounter for closed fracture
- Relevant for patients with a left radius fracture requiring immobilization, also an upper extremity injury.
S62.501A - Unspecified fracture of the right hand, initial encounter for closed fracture
- Indicates a right hand fracture; may require immobilization but typically not a body cast.
S62.502A - Unspecified fracture of the left hand, initial encounter for closed fracture
- Indicates a left hand fracture; similar relevance as above.
M84.431A - Stress fracture, right radius, initial encounter
- Represents a stress fracture of the right radius; immobilization may be needed, but a body cast is uncommon for this diagnosis.

These diagnoses are associated with fractures that may require immobilization, though the body cast described by CPT code 29044 is most relevant for more extensive injuries involving the trunk and thigh.

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Summary & Overview

CPT 29044: Application of Body Cast, Shoulder to Hips and Down One Thigh

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

National Reimbursement Benchmarks

Related Codes

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

Related Codes