Summary & Overview
HCPCS Level II A4580: Cast Supplies (Plaster)
HCPCS Level II code A4580 denotes cast supplies (e.g., plaster) used in the immobilization and management of fractures and other orthopedic conditions. Nationally, the code is relevant for providers and payers managing supply line items in outpatient and facility-based musculoskeletal care, where cast materials represent a routine but essential component of treatment cost and logistics. Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides a concise reference to what A4580 represents, typical sites of service, and the clinical context for use. Readers will find benchmarks and billing considerations for supply line reporting, an overview of common modifiers associated with supply and procedure billing, and notes on documentation and claim submission practices. The summary covers payer coverage patterns and coding pitfalls that can affect claim acceptance and reimbursement. Where specific comparative data or auxiliary taxonomies are not provided, the report notes that the input data is not available. Intended readers include revenue cycle leaders, orthopedic clinicians, and policy analysts seeking a national view of how cast supply charges are reported and processed.
Billing Code Overview
HCPCS Level II code A4580 describes cast supplies (e.g., plaster) used for immobilization in musculoskeletal care. The service type is durable medical/supplies for splinting and casting, typically supplied as part of orthopedic treatment or fracture management. The typical site of service is outpatient clinics, emergency departments, urgent care centers, and hospital outpatient departments where casts or splints are applied or replaced.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient presents to an urgent care or orthopedic clinic after sustaining an acute closed forearm fracture during a fall while playing sports. Initial evaluation includes history, focused physical exam, and radiographs confirming a nondisplaced radius fracture. The treating clinician performs reduction if needed and applies a plaster cast for immobilization using materials billed under A4580 (cast supplies, e.g., plaster). The clinical workflow: triage → clinician evaluation → diagnostic imaging (if indicated) → fracture management (closed reduction when required) → cast application using plaster rolls, padding, and stockinette documented as supplies under A4580 → patient education on cast care and follow-up scheduling. Typical site of service is outpatient clinics, urgent care centers, emergency departments, and ambulatory surgical centers. Typical patient scenarios also include immobilization of sprains, stable wrist fractures, foot or ankle injuries, and temporary immobilization after minor procedures where plaster casting materials are used.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier. | Use when no special circumstance modifier applies. |