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2025 CPT code 29710

Removal or bivalving of shoulder or hip spica, Minerva, or Risser jacket casts.

Codes for cast removal should only be used when the cast was applied by a different physician or qualified healthcare professional. The removal procedure is typically not separately billable if the same provider applied the cast. Modifier 50 (Bilateral Procedure) may be appended if the procedure is performed bilaterally.Appropriate E/M codes should be reported if significant evaluation and management services are provided on the same day.

Modifiers such as 50 (Bilateral Procedure), RT (Right side), and LT (Left side) may apply depending on the specific circumstances.Modifier 76 (Repeat procedure) may apply if the same physician performs a repeat procedure.Modifier 25 (Significant, separately identifiable evaluation and management service) may be used if an EM service is also performed.

Medical necessity is established when the cast removal is required due to completed healing, excessive swelling, or other clinically justifiable reasons.Documentation needs to clearly support the medical need for the procedure.

The physician or qualified healthcare professional is responsible for the safe and effective removal or bivalving of the cast, assessment of the underlying tissues, and appropriate aftercare instructions.

IMPORTANT:29700 (Removal or bivalving; gauntlet, boot, or body cast), 29705 (Removal or bivalving; full arm or full leg cast).These codes are used for different types of casts.If the cast was applied by the same physician, the removal might be bundled into the original procedure and not separately billable.

In simple words: The doctor removes or cuts open a large cast (shoulder or hip spica, Minerva, or Risser type) from a patient's body.They use special tools to avoid hurting the skin underneath.Sometimes, they cut the cast in half to reduce swelling, and then put the halves back together temporarily.

This CPT code encompasses the removal or bivalving (cutting a cast into two halves) of specific types of casts: shoulder or hip spica casts, Minerva casts, and Risser jacket casts.The procedure involves using specialized instruments such as a cast saw and spreader to carefully remove the cast without harming the underlying tissues.Bivalving may be performed to relieve swelling or pressure, with the cast halves subsequently secured if healing isn't complete.Assessment of the underlying skin and adjustments to the cast (if bivalving) are included.

Example 1: A patient presents with a hip spica cast applied by a physician in another state following a hip fracture.The cast needs removal after sufficient healing. 29710 is reported., A patient has a Minerva cast applied for cervical spine stabilization following trauma. The cast needs removal after appropriate healing. 29710 is reported., A patient has a shoulder spica cast which is too tight due to swelling. The cast needs bivalving and readjustment. 29710 is reported.

Detailed documentation should include the type of cast, reason for removal (e.g., healing complete, swelling, etc.), date of initial cast application (if different provider), and any findings upon cast removal (e.g., skin integrity, wound healing).Documentation of the removal procedure itself (e.g., use of cast saw, spreader, etc.) is also essential.

** Careful attention should be paid to payer-specific guidelines regarding bundled services. The use of this code requires adherence to CPT guidelines, including the stipulation that it should only be used if the cast was applied by a different provider.

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