Gauntlet Cast Application: CPT Coding and Medicare Status

There is no unique CPT code specifically for "gauntlet cast" (thumb spica + short arm). Instead, use existing cast application codes based on the extent of immobilization.

Correct Coding

• 29075 – Application, cast; elbow to finger (short arm) – includes gauntlet/thumb spica.
• 29085 – Application, cast; hand and lower forearm (gauntlet).
• Select based on extent; both encompass thumb inclusion.
• Cast supplies (fiberglass, plaster) reported separately (99070 or specific supply codes).

Medicare / CMS Status

• Both 29075 and 29085 are payable under the Medicare Physician Fee Schedule.
• Global period: 0-day (procedure only).
• Documentation must support medical necessity (fracture, severe sprain, post-op immobilization).

The claim that gauntlet casts are "not recognized by CMS" is incorrect; these are standard, billable cast codes.