Application, cast; hand and lower forearm (gauntlet)

CPT 29085 is the billing code for "Application, cast; hand and lower forearm (gauntlet)". For application of gauntlet cast for hand and lower forearm

Medicare pays approximately $97.36 for CPT 29085 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 29085 has a total RVU of 3.28, broken down as: Work RVU 1.80, Practice Expense RVU 1.30, and Malpractice RVU 0.18. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 29085 include: Indication for gauntlet cast; Type of cast applied; Cast material used; Patient positioning. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 29085: Includes cast application. Includes cast materials Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 29085 include: 50 (Bilateral procedure when both hands casted same session), 51 (Multiple procedures performed same session), LT (Left side procedure). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 29085 is 10-20 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.