CPT® Code 29710

Bivalving a cast is a procedure that involves making incisions on both sides of a cast to alleviate excessive pressure on the body part that has been immobilized. This situation often arises due to swelling or distension of the affected area. The procedure is typically performed using an oscillating saw, which is specifically designed to cut through the cast material and the padding without causing harm to the underlying skin or tissues. The incisions are strategically placed to ensure that the cast continues to provide adequate support to the injured body part while allowing for necessary adjustments as swelling decreases. After the bivalving process, an elastic wrap is applied over the cast to maintain stability and can be adjusted as the swelling subsides. In cases where complete removal of the cast is required, the oscillating saw is again utilized to cut the cast on both sides, followed by the careful use of scissors to cut through the underlying padding and stockinette. Once the cast is removed, the skin is thoroughly inspected for any signs of breakdown or irritation. This procedure is specifically indicated for shoulder or hip spica casts, Minerva casts, or Risser jackets, and is distinct from other casting procedures that may involve different types of casts, such as gauntlets, boots, or full arm or leg casts.