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CPT®
29715

CPT® Code 29715
Deleted

Official Description

Removal or bivalving; turnbuckle jacket

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

Bivalving a cast is a procedure that involves creating openings on both sides of a cast to alleviate excessive pressure that may arise due to swelling or distension of the body part that has been immobilized. This technique is particularly important in managing patient comfort and preventing complications associated with tight casts, such as skin breakdown or impaired circulation. The procedure typically employs an oscillating saw, which is specifically designed to safely cut through the cast material and the underlying padding without causing harm to the skin or the underlying tissues. The cuts are strategically made to ensure that the cast continues to provide adequate support to the injured area while allowing for necessary adjustments as swelling decreases. Following the bivalving, an elastic wrap is applied over the cast to maintain stability and can be adjusted as the patient's condition improves. 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 cutting of the padding and stockinette with scissors. After the cast is removed, it is essential to inspect the skin for any signs of breakdown or irritation, ensuring that the patient’s recovery can proceed without further complications.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure of bivalving or removing a turnbuckle jacket cast is indicated in specific situations where the cast may be causing discomfort or complications for the patient. The following conditions warrant this procedure:

  • Excessive Swelling - When the body part under the cast experiences significant swelling, bivalving helps relieve pressure and prevent further complications.
  • Distension - Similar to swelling, distension can occur due to various factors, necessitating the need to open the cast for patient comfort and safety.
  • Skin Irritation or Breakdown - If there are signs of skin irritation or breakdown under the cast, it is crucial to remove or bivalve the cast to assess and treat the affected area.

2. Procedure

The procedure for bivalving or removing a turnbuckle jacket cast involves several key steps to ensure patient safety and comfort. Each step is critical to the overall success of the procedure.

  • Step 1: Preparation - The healthcare provider prepares the necessary tools, including an oscillating cast saw, scissors, and elastic wrap. The patient is positioned comfortably to allow easy access to the casted area.
  • Step 2: Bivalving the Cast - The oscillating saw is carefully used to make cuts on both sides of the cast. These cuts are made in a controlled manner to relieve pressure while maintaining adequate support for the injured body part. The provider ensures that the saw does not come into contact with the skin.
  • Step 3: Application of Elastic Wrap - After bivalving, an elastic wrap is applied over the cast. This wrap provides additional support and can be adjusted as the swelling decreases, allowing for continued immobilization of the injured area.
  • Step 4: Removal of the Cast - If complete removal of the cast is necessary, the oscillating saw is again utilized to cut through the cast on both sides. Following this, scissors are used to cut the underlying padding and stockinette, allowing for the safe removal of the cast.
  • Step 5: Skin Inspection - Once the cast is removed, the healthcare provider inspects the skin for any signs of breakdown, irritation, or other complications. This step is crucial for ensuring the patient's skin integrity and overall recovery.

3. Post-Procedure

After the procedure, it is important to monitor the patient for any signs of discomfort or complications. The area where the cast was applied should be observed for swelling, redness, or skin breakdown. The healthcare provider may provide instructions on how to care for the skin and manage any discomfort. Follow-up appointments may be necessary to assess the healing process and determine if further intervention is required. Additionally, the patient should be educated on the importance of reporting any unusual symptoms that may arise after the cast has been bivalved or removed.
Short Descr REMOVAL/REVISION OF CAST
Medium Descr REMOVAL/BIVALVING TURNBUCKLE JACKET
Long Descr Removal or bivalving; turnbuckle jacket
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) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - 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, Not Discounted when Multiple
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE Not applicable/unspecified.
CCS Clinical Classification 163 - Other non-OR therapeutic procedures on musculoskeletal system
Date
Action
Notes
2015-01-01 Deleted Code deleted
Pre-1990 Added Code added.
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