CPT 29345: Long Leg Cast Application, Leg and Knee Immobilization - OpenPayer

Summary & Overview

CPT 29345: Long Leg Cast Application, Leg and Knee Immobilization

CPT code 29345 denotes application of a long leg cast to immobilize the leg and knee for fractures and deformity correction. This procedure is a fundamental orthopedic immobilization technique used across acute care and outpatient settings to stabilize fractures of the tibia, fibula, ankle, and related structures while protecting the knee joint. Nationally, proper coding and documentation of cast application affect care coordination, post-procedure management, and accurate claim adjudication for both facility and professional services.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications tied to common ICD-10 fracture diagnoses, the typical sites of service where 29345 is billed, and related supply and follow-up codes such as cast removal and splint supply Q-codes. The publication outlines common billing considerations, related procedure groupings, and code relationships that influence coverage and claim routing.

This summary provides clinical context for when 29345 is appropriate, identifies linked services and supplies, and highlights information useful for coding accuracy, claims preparation, and administrative workflows. Data not available in the input is explicitly noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare29345CPTcast-applicationorthopedicsfracture-managementimmobilizationlong-leg-castprocedure-coding

Billing Code Overview

CPT code 29345 describes the application of a long leg cast that immobilizes the leg and knee. The cast extends from the thigh down over the foot while leaving the toes free and is used to treat fractures of the leg bones and to correct deformities of the knee, distal leg, ankle, and foot.

Service Type: Cast application / immobilization (long leg cast)

Typical Site of Service: Hospital inpatient or outpatient orthopedic department, emergency department, ambulatory surgery center, or other settings where orthopedic immobilization is provided.

Clinical & Coding Specifications

Clinical Context

A 28-year-old male presents to the emergency department after a motorcycle collision with acute pain, swelling, and deformity of the lower leg. Plain radiographs demonstrate an acute, closed, non-displaced fracture of the midshaft of the right tibia (S82.301A). After neurovascular exam and tetanus status review, the orthopedic provider performs closed reduction as needed and applies a long leg cast to immobilize the knee and tibia while maintaining alignment. The procedure is documented as application of a long leg cast (CPT 29345) extending from the thigh to the foot with toes exposed. The typical clinical workflow includes patient assessment, informed consent, analgesia or conscious sedation if required, closed reduction (if indicated), cast application, post-application neurovascular check, and discharge with cast care instructions and scheduled orthopedic follow-up.

Coding Specifications

Modifier	Description	When to Use
`RT`	Right side	Use when the long leg cast is applied to the right lower extremity.
`LT`

Related Codes

97551

CPT 97551: Caregiver Training for Functional Performance, Face-to-Face

99318

CPT 99318: Annual Evaluation and Management in Nursing Facility

29085

CPT 29085: Application of Hand and Lower Forearm Gauntlet Cast

29130

CPT 29130: Application of Static Finger Splint

cpt-29355-long-leg-ambulatory-cast-application

CPT 29355: Long Leg Ambulatory Cast Application

29515

CPT 29515: Application of Short Leg Splint (Calf to Foot)

cpt-29055-shoulder-spica-semi-full-body-cast

CPT 29055: Semi‑Full Body Shoulder Spica Cast Application

cpt-97597-wound-debridement-active-management-20cm2-or-less

CPT 97597: Selective Debridement of Devitalized Tissue, Wound ≤20 cm2

97129

CPT 97129: Cognitive Therapeutic Interventions, Initial 15 Minutes

cpt-29105-upper-and-lower-arm-splint-application

CPT 29105: Upper and Lower Arm Splint Application

Showing 1–10 of 191

Taxonomy Code	Specialty	Notes
`207X00000X`	Orthopedic Surgery	Primary specialty performing fracture care and cast application.
`207XX0004X`	Orthopaedic Trauma	Subspecialty focused on acute traumatic lower extremity fractures and immobilization.
`207XS0117X`	Surgical Sports Medicine	Providers who may manage complex sports-related tibial fractures and immobilization.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`S82.401A`	Unspecified fracture of lower end of right tibia, initial encounter for closed fracture	Right distal tibial fracture pattern that may require immobilization with a long leg cast to protect the tibia and ankle while healing.
`S82.402A`	Unspecified fracture of lower end of left tibia, initial encounter for closed fracture	Left distal tibial fracture that can be managed initially with long leg casting when appropriate.
`S82.301A`	Unspecified fracture of shaft of right tibia, initial encounter for closed fracture	Midshaft right tibial fracture commonly immobilized with a long leg cast to maintain alignment and limit knee motion.
`S82.302A`	Unspecified fracture of shaft of left tibia, initial encounter for closed fracture	Midshaft left tibial fracture suitable for long leg cast immobilization in select cases.
`M84.461A`	Pathological fracture, right tibia, initial encounter for fracture	Pathologic right tibial fracture where a long leg cast may be used for immobilization during initial management pending further evaluation.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29700-29750`	Cast removal or repair	Used when cast removal or repair is provided, especially if another physician group originally applied the cast or follow-up requires repair.
`Q4029 through Q4032`	Splints and cast Q-codes (supplies)	Supplies and device billing codes associated with casting materials used during or after application of the long leg cast.