Summary & Overview
CPT 29105: Application of Long Arm Splint (Shoulder to Hand)
CPT code 29105 represents the application of a long arm splint, a critical procedure used to immobilize the arm from shoulder to hand following fractures or significant musculoskeletal injuries. This service is widely performed in ambulatory and office settings by orthopaedic surgeons and emergency medicine physicians, playing a vital role in patient care and recovery. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, ensuring broad coverage and reimbursement for providers.
This publication provides a comprehensive overview of CPT 29105, including payer coverage, clinical context, and related billing codes. Readers will gain insights into typical use cases, associated diagnoses, and relevant modifiers, as well as comparisons to related splint application codes. The analysis highlights current policy updates, benchmarks, and clinical considerations for the application of long arm splints, offering a clear understanding of its importance in musculoskeletal care. The information is designed for healthcare professionals, billing specialists, and policy analysts seeking up-to-date knowledge on procedural coding and payer policies for splint applications.
CPT Code Overview
CPT 29105 describes the application of a long arm splint, extending from the shoulder to the hand. This procedure is commonly performed to immobilize the arm following fractures or injuries, ensuring proper healing and alignment. It falls under the category of surgical procedures on the musculoskeletal system and is typically provided in an ambulatory or office setting such as Office – POS 11. The use of a long arm splint is a standard intervention in orthopaedic and emergency medicine, supporting patient recovery and preventing further injury.
Clinical & Coding Specifications
Clinical Context
A patient presents to the ambulatory office setting after sustaining a closed fracture of the shaft of the humerus or forearm bones (radius or ulna) following a fall or trauma. The provider, typically an orthopaedic surgeon, orthopaedic trauma specialist, or emergency medicine physician, evaluates the injury and determines that immobilization is required. The clinical workflow involves assessing the fracture, confirming the diagnosis with imaging, and then applying a long arm splint from the shoulder to the hand to stabilize the affected limb. The procedure is performed to prevent further injury, reduce pain, and facilitate healing prior to definitive treatment or as part of initial management.
Coding Specifications
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Modifiers:
LT: Indicates the procedure was performed on the left side.RT: Indicates the procedure was performed on the right side.
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Provider Taxonomies:
Code Specialty 207X00000XOrthopaedic Surgery 207XX0004XOrthopaedic Trauma 207P00000XEmergency Medicine Physician
These taxonomies represent providers who commonly perform the application of a long arm splint in the office or emergency setting.
Related Diagnoses
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S42.401A: Unspecified fracture of shaft of humerus, right arm, initial encounter for closed fracture- Relevant for patients with a humerus shaft fracture requiring immobilization with a long arm splint.
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S52.501A: Unspecified fracture of the lower end of right radius, initial encounter for closed fracture- Indicates a distal radius fracture, which may necessitate a long arm splint if stability is needed.
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S52.301A: Unspecified fracture of shaft of radius, right arm, initial encounter for closed fracture- Used for shaft fractures of the radius, often managed with a long arm splint for proper immobilization.
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S52.201A: Unspecified fracture of shaft of ulna, right arm, initial encounter for closed fracture- Applies to ulna shaft fractures, where a long arm splint is indicated to stabilize the forearm.
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S42.202A: Unspecified fracture of shaft of humerus, left arm, initial encounter for closed fracture- Used for left arm humerus shaft fractures, requiring immobilization from shoulder to hand.
Related CPT Codes
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29125: Application of non‑moveable, short arm splint (forearm to hand)- Used for immobilization of injuries limited to the forearm or wrist, not requiring shoulder immobilization. Alternative to
29105for less extensive injuries.
- Used for immobilization of injuries limited to the forearm or wrist, not requiring shoulder immobilization. Alternative to
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29126: Application of moveable, hinged short arm splint (forearm to hand)- Allows for some movement at the elbow. Used for injuries where partial mobility is desired. Alternative to
29105for less severe injuries.
- Allows for some movement at the elbow. Used for injuries where partial mobility is desired. Alternative to
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29130: Application of non‑moveable, hinged finger splint- Used for finger fractures or injuries. Not typically used with
29105, but may be applied for concurrent finger injuries.
- Used for finger fractures or injuries. Not typically used with
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29131: Application of moveable, hinged finger splint- Used for finger injuries requiring some movement. Not commonly used with
29105, but may be considered for complex hand injuries.
- Used for finger injuries requiring some movement. Not commonly used with
These codes are alternatives or adjuncts to 29105 depending on the location and severity of the injury. 29125 and 29126 are most commonly considered as alternatives for forearm or wrist injuries.
National Reimbursement Benchmarks
Medicare's national mean rate for CPT code 29105 is $100.28, while the average commercial benchmark (BUCA) is slightly lower at $95.26. Among individual commercial payers, UnitedHealth Group and Cigna have the highest mean rates at $124.94 and $118.08, respectively, both exceeding Medicare's average.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. Medicare exhibits the tightest range at $10.00, indicating relatively consistent reimbursement. In contrast, UnitedHealth Group and Cigna show the widest dispersions, with ranges of $64.87 and $62.00, respectively, reflecting greater variability in commercial rates. Aetna and Blue Cross Blue Shield have moderate ranges of $35.69 and $40.67.
The table and chart below present a detailed breakdown of national benchmarks for each payer, including mean rates and percentile values.
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