Summary & Overview
CPT 29355: Long Leg Ambulatory Cast Application
Headline: CPT code 29355: Long Leg Ambulatory Cast Application for Lower Extremity Immobilization
CPT code 29355 covers the application of a long leg ambulatory cast that immobilizes the leg and knee, used to manage fractures and deformities while permitting ambulation with a cast shoe or footplate. This code captures a common, resource-focused procedural service in orthopedic and trauma care that influences facility and professional billing for outpatient fracture management nationwide. It is relevant to orthopedic surgeons, emergency and ambulatory clinic providers, and revenue cycle teams processing fracture-related encounters.
Major national payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and service setting, comparisons to closely related cast application codes, and information on typical billing considerations affecting reimbursement and documentation. The publication outlines expected diagnoses that commonly map to this service and identifies where clinicians will most often perform the procedure. It also summarizes what to review in claims and policy language when coding for long leg ambulatory casts, and highlights areas for attention in claims submission and audit preparedness. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 29355 describes the application of a long leg ambulatory cast that immobilizes the leg and knee. The cast extends from the thigh down over the foot while leaving the toes free. The provider forms the bottom of the cast to accommodate a cast shoe that straps on over the cast and permits ambulation when the patient can bear weight on that leg, or alternatively applies a footplate and rubber heel to the bottom of the cast.
Service type: Cast application – ambulatory long leg cast
Typical site of service: Hospital outpatient department, ambulatory surgery center, or clinic/office setting where cast application and outpatient fracture care are provided.
Clinical & Coding Specifications
Clinical Context
A 34-year-old patient presents to the orthopedic clinic after sustaining a closed tibial fracture during a fall. The provider evaluates the patient with history, physical exam, and radiographs confirming an acute closed fracture of the tibia. The patient is counseled that nonoperative immobilization is appropriate; the provider applies a long leg ambulatory cast (CPT 29355) that extends from the thigh to the foot with toes left free. The cast is molded to immobilize the knee and leg, and the cast bottom is formed to accept a cast shoe or a footplate with a rubber heel to permit protected ambulation when weight bearing is allowed. Typical workflow includes informed consent, pre-procedure neurovascular check, selection and application of stockinette and padding, placement of casting material with appropriate molding, post-application neurovascular check, patient education on cast care and weight-bearing status, and scheduling follow-up for cast checks and radiographic monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When the long leg cast is applied to the left lower extremity. |
RT |