Summary & Overview
CPT 29049: Application of Figure‑of‑Eight Cast
CPT code 29049 covers the application of a figure‑of‑eight cast, a widely used orthopedic procedure for immobilizing fractures and injuries of the upper extremity. This code is relevant for both general and specialized orthopedic practices, reflecting a standard of care in fracture management across the United States. The procedure is typically performed in physician offices or outpatient facilities, allowing for efficient treatment and stabilization of musculoskeletal injuries.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare, recognize and reimburse for this service, underscoring its importance in clinical and billing workflows. Readers will gain insight into payer coverage, clinical indications, and related coding benchmarks, as well as recent policy updates affecting cast application services. The publication also provides context on associated diagnoses and related CPT codes, helping stakeholders understand the broader landscape of orthopedic billing and compliance.
This summary offers a comprehensive overview of the clinical and administrative aspects of CPT code 29049, equipping healthcare professionals, billing specialists, and policy analysts with the information needed to navigate reimbursement and regulatory requirements for figure‑of‑eight cast applications.
CPT Code Overview
CPT code 29049 describes the application of a figure‑of‑eight cast, a procedure commonly performed in orthopedic and general clinical settings to immobilize and support injuries, particularly fractures of the upper extremity. This service is typically provided in a physician office or outpatient facility, ensuring prompt stabilization and comfort for patients with musculoskeletal injuries. The figure‑of‑eight cast technique is designed to maintain proper alignment and facilitate healing, making it a standard approach in fracture management.
Clinical & Coding Specifications
Clinical Context
A patient presents to the physician office or outpatient facility with a closed fracture of the upper extremity, such as the shaft of the humerus or the lower end of the radius. The orthopedic provider evaluates the injury, confirms the diagnosis, and determines that immobilization is required. A figure‑of‑eight cast is applied to stabilize the fracture and promote healing. The procedure is performed by an orthopedic surgeon, trauma specialist, or hand surgeon, depending on the injury location. The cast application is documented, and the appropriate laterality modifier is selected based on the affected limb.
Coding Specifications
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Modifiers:
LT: Indicates the procedure was performed on the left side.RT: Indicates the procedure was performed on the right side.
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Provider Taxonomies:
Taxonomy Code Specialty Name 207X00000XOrthopaedic Surgery 207XX0004XOrthopaedic Trauma 207XS0117XSurgery of the Hand
These taxonomies represent providers specializing in orthopedic surgery, trauma care, and hand surgery, all of whom may perform cast applications for upper extremity fractures.
Related Diagnoses
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S42.401A- Unspecified fracture of shaft of humerus, right arm, initial encounter for closed fracture- Relevant for figure‑of‑eight cast application to immobilize the humerus in the right arm.
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S42.402A- Unspecified fracture of shaft of humerus, left arm, initial encounter for closed fracture- Indicates a left arm humerus fracture requiring immobilization with a figure‑of‑eight cast.
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S52.501A- Unspecified fracture of the lower end of right radius, initial encounter for closed fracture- Used when a right radius fracture is present, often necessitating cast application for stabilization.
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S52.502A- Unspecified fracture of the lower end of left radius, initial encounter for closed fracture- Applies to left radius fractures, where a figure‑of‑eight cast may be indicated.
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S52.91XA- Unspecified fracture of right forearm, initial encounter for closed fracture- Represents a right forearm fracture, which may be managed with a figure‑of‑eight cast depending on injury specifics.
Each diagnosis code corresponds to a clinical scenario where immobilization with a figure‑of‑eight cast (29049) is appropriate for initial fracture management.
Related CPT Codes
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29055- Application, cast, shoulder spica- Used for immobilizing the shoulder and upper arm, often for more complex or proximal fractures.
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29058- Application, cast, plaster Velpeau- Applied for shoulder and upper arm immobilization, typically in cases where abduction is required.
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29065- Application, cast, shoulder to hand long arm- Used for immobilizing the entire arm from shoulder to hand, suitable for extensive fractures.
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29075- Application, cast, elbow to finger short arm- Applied for forearm and wrist fractures, immobilizing from elbow to fingers.
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29085- Application, cast, hand & lower forearm gauntlet- Used for fractures involving the hand and lower forearm, providing targeted immobilization.
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29086- Application, cast, finger- Applied for isolated finger fractures, offering localized support.
These codes are related to 29049 as alternative or adjunct cast applications for upper extremity fractures. Selection depends on fracture location and required immobilization. Some codes may be used together in complex injury scenarios, while others serve as alternatives based on clinical need.