Summary & Overview
CPT 29058: Plaster Velpeau Cast, Upper Forearm and Shoulder
CPT code 29058 documents the application of a plaster Velpeau cast that immobilizes the upper forearm and shoulder by securing a flexed forearm against the trunk. Used for fractures of the humerus, scapula, clavicle and for stabilization after closed reduction of glenohumeral, sternoclavicular, or acromioclavicular dislocations, this code captures a common, procedure-driven intervention in acute musculoskeletal care. It matters nationally because immobilization procedures impact emergency and orthopedic workflow, resource use, and post-procedure follow-up care patterns.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for 29058, how the service is typically delivered, and where it is performed. The publication summarizes payer coverage considerations and common billing practices, highlights associated procedure code groupings, and outlines clinical indications tied to relevant ICD-10 diagnoses provided in the input. This resource is intended for clinicians, billing professionals, and policy analysts seeking a national-level briefing on coding, clinical use cases, and payer coverage scope for upper-arm Velpeau cast application.
Billing Code Overview
CPT code 29058 describes the application of a plaster Velpeau cast to the upper forearm and shoulder. The cast holds a flexed forearm against the patient's trunk and prevents movement of the shoulder, elbow, and forearm in the treatment of fractures or after closed reduction of dislocations.
Service Type: Cast application / immobilization of upper extremity
Typical Site of Service: Emergency department, urgent care, or orthopedic clinic
Clinical & Coding Specifications
Clinical Context
A 48-year-old male presents to the emergency department after a fall from a ladder with severe right shoulder and proximal arm pain, deformity, and limited shoulder and elbow motion. Radiographs demonstrate a displaced mid-shaft humeral fracture with concern for potential instability; after neurovascular assessment and appropriate analgesia, the orthopaedic or emergency medicine provider performs a closed reduction as indicated and applies a plaster Velpeau (upper forearm and shoulder) cast to immobilize the shoulder and elbow in flexion against the trunk. The cast prevents movement of the glenohumeral, acromioclavicular, and sternoclavicular joints and stabilizes the humerus while soft tissues and the fracture begin to heal. Typical workflow includes pre-procedure informed consent, neurovascular exam documentation, description of reduction maneuvers if performed, application technique and materials used, post-application neurovascular reassessment, cast care instructions documented in the record, and scheduling of follow-up radiographs and clinic evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the Velpeau cast is applied to the left upper extremity |
RT | Right side |