CPT® Code 29700

Bivalving a cast is a procedure that involves making incisions on both sides of a cast, which is typically applied to immobilize a body part following an injury. This technique is particularly important when there is excessive pressure on the casted area due to swelling or distension, which can occur as the body heals. The procedure is performed using an oscillating saw, which allows for precise cuts through the cast material and any padding that may be present. The goal of bivalving is to relieve pressure while still maintaining adequate support for the injured body part, ensuring that the healing process is not compromised. After the cast is bivalved, an elastic wrap is applied over the cast to provide additional support and can be adjusted as swelling decreases. In cases where the cast needs to be completely removed, the same oscillating saw is utilized to cut through the cast on both sides, followed by the careful cutting of the underlying padding and stockinette with scissors. Once the cast is removed, it is essential to inspect the skin for any signs of breakdown or irritation that may have occurred during the casting period. This procedure is specifically coded as CPT® Code 29700, which pertains to the removal or bivalving of a gauntlet, boot, or body cast.