CPT® Code 29445

A rigid total-contact leg cast is a specialized orthopedic device designed to immobilize the leg while providing support and protection to the foot and ankle. This type of cast extends all the way to the toes, ensuring comprehensive coverage and stabilization. It is particularly utilized in the treatment of plantar ulcers, which are open sores that develop on the bottom of the foot, often due to conditions such as peripheral neuropathy. Peripheral neuropathy can lead to sensory loss, making patients less aware of injuries or pressure on their feet, which can result in repetitive walking stress and the formation of these ulcers. By applying a total-contact leg cast, the plantar stress is alleviated, thereby promoting the healing process of the ulcers. The application process involves several steps, starting with the placement of a stockinette to protect the skin, followed by padding to cushion the area. A single layer of plaster is then wrapped around the leg, typically starting from the distal (far) end and moving towards the proximal (near) end, and is finished with a layer of fiberglass tape for added strength and durability.