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2025 CPT code 29058

Application of a plaster Velpeau cast.

The application and removal of the first cast, splint, or traction device are included in musculoskeletal system procedures. Subsequent replacements may be reported separately. Modifier 54 can be used if the initial provider is not performing subsequent care.

Modifiers may be applicable. For instance, modifier 22 (Increased Procedural Services) would be used if the procedure was significantly more complex than usual, or modifier 76 (Repeat Procedure or Service by Same Physician) if the same physician re-applied the cast.

Medical necessity for a Velpeau cast is established by the underlying condition requiring immobilization, such as a fracture, dislocation, or other injury to the shoulder or upper arm.

The physician positions the patient's injured arm across their chest, applies padding for protection, wraps gauze or padding around the arm and shoulder, and then applies the plaster of Paris. After the cast dries, the fit is checked and trimmed if necessary.

In simple words: A plaster cast is applied to your upper arm and shoulder to keep it from moving. This is often used for broken bones or dislocations in the shoulder area.

Application of a plaster Velpeau cast to immobilize the shoulder and forearm. This cast extends from the shoulder to the hand, holding the forearm flexed against the trunk. It restricts movement in all involved joints. This procedure is typically used for fractures of the humerus, scapula, or clavicle, or after reduction of dislocated glenohumeral, sternoclavicular, or acromioclavicular joints.

Example 1: A patient presents with a fractured humerus. A plaster Velpeau cast is applied to immobilize the fracture and facilitate healing., A patient has a dislocated glenohumeral joint that was recently reduced. A plaster Velpeau cast is applied to stabilize the joint and prevent re-dislocation., A patient suffers a clavicle fracture. A Velpeau cast is applied to immobilize the shoulder and promote bone healing.

Documentation should include the reason for the cast application (e.g., fracture, dislocation), the location and type of cast applied (plaster Velpeau), and any associated procedures performed (e.g., reduction of dislocation). Additionally, document the patient's condition before and after cast application, neurovascular status, and any patient education provided.

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