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Official Description

Application of short leg cast (below knee to toes);

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The procedure described by CPT® Code 29405 involves the application of a short leg cast, which is a type of immobilization device used to support and protect the lower leg. This cast specifically extends from just below the knee down to the toes, providing stability to the ankle and foot while allowing for the healing of fractures, sprains, or other injuries in that area. The application of a cast is a common practice in orthopedic medicine, aimed at preventing movement of the affected limb to facilitate proper healing. It is important to note that if additional padding or a brace is incorporated into the cast to enable the patient to walk, the appropriate code to use would be CPT® Code 29425. This distinction is crucial for accurate medical coding and billing, ensuring that the procedure is documented correctly based on the specific materials and methods used during the casting process.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The application of a short leg cast (CPT® Code 29405) is indicated for various conditions affecting the lower leg, ankle, and foot. These may include:

  • Fractures - The cast is commonly used to immobilize broken bones in the lower leg, ensuring that the fragments remain in proper alignment during the healing process.
  • Sprains - In cases of severe ankle or foot sprains, a cast may be applied to restrict movement and provide support to the injured ligaments.
  • Post-surgical support - After certain surgical procedures on the lower leg or foot, a cast may be necessary to protect the surgical site and maintain stability.

2. Procedure

The procedure for applying a short leg cast involves several key steps to ensure proper immobilization and support of the affected limb. These steps include:

  • Preparation of the limb - The physician begins by assessing the patient's leg for any injuries or conditions that necessitate casting. The skin is cleaned and inspected to ensure there are no open wounds or infections that could complicate the casting process.
  • Application of padding - Soft padding material is wrapped around the leg, starting just below the knee and extending down to the toes. This padding serves to protect the skin from irritation and pressure from the cast material.
  • Application of the cast material - Once the padding is in place, the physician applies the casting material, which is typically a fiberglass or plaster substance. The material is molded around the leg, ensuring that it conforms closely to the contours of the limb for optimal support.
  • Setting the cast - After the cast material is applied, it is allowed to set and harden. The physician checks for proper fit and comfort, ensuring that the cast is not too tight, which could impede circulation.
  • Final assessment - Once the cast has hardened, the physician performs a final assessment to ensure that the cast is secure and that the patient understands care instructions, including how to keep the cast dry and what signs of complications to watch for.

3. Post-Procedure

After the application of the short leg cast, the patient is typically advised on several important post-procedure care instructions. These may include keeping the cast dry and avoiding submersion in water, as moisture can weaken the cast material. Patients are also instructed to monitor for any signs of complications, such as increased pain, swelling, or changes in skin color or temperature around the cast. Follow-up appointments are usually scheduled to assess the healing process and to determine when the cast can be safely removed. The duration of cast wear can vary depending on the specific injury and the patient's healing progress.

Short Descr APPLY SHORT LEG CAST
Medium Descr APPLICATION SHORT LEG CAST BELOW KNEE-TOE
Long Descr Application of short leg cast (below knee to toes);
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 1
CCS Clinical Classification 214 - Traction, splints, and other wound care
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
GP Services delivered under an outpatient physical therapy plan of care
KX Requirements specified in the medical policy have been met
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AF Specialty physician
AG Primary physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CR Catastrophe/disaster related
GA Waiver of liability statement issued as required by payer policy, individual case
GC This service has been performed in part by a resident under the direction of a teaching physician
GO Services delivered under an outpatient occupational therapy plan of care
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
PO Excepted service provided at an off-campus, outpatient, provider-based department of a hospital
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SA Nurse practitioner rendering service in collaboration with a physician
ST Related to trauma or injury
T4 Left foot, fifth digit
X2 Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
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Notes
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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