Summary & Overview
HCPCS Q4005: Cast Supplies, Long Arm Plaster, Adult (11+)
HCPCS Level II code Q4005 identifies cast supplies for a long arm plaster cast for adults (11 years and older). This supplies-only code captures the materials component of upper-extremity immobilization and is relevant to emergency departments, orthopedic clinics, and outpatient settings where casting is performed. Accurate use of Q4005 ensures appropriate tracking of supply utilization and supports correct claim submission when casting materials are billed separate from professional services.
Key national payers for this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the code’s clinical context, common sites of service, and the payer landscape. The publication summarizes typical billing considerations, common modifiers in use (listed in the detailed sections), and how Q4005 relates to supply-only charge capture for long arm plaster casts.
This resource provides benchmarks and policy notes relevant to supply billing practices, highlights administrative considerations for claim submission, and outlines where to find related coding guidance. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4005 describes cast supplies for a long arm cast for adults (11 years and older), plaster. The service pertains to the provision of materials used to fabricate and maintain a long arm plaster cast for upper extremity immobilization in adults and adolescents aged 11 and older.
Service type: Durable medical/supplies — casting materials
Typical site of service: Outpatient clinic, emergency department, orthopedics clinic, or ambulatory surgical center where casting and immobilization are performed
Clinical & Coding Specifications
Clinical Context
An adult patient (age ≥11 years) presents to an urgent care clinic or orthopedic outpatient clinic after a distal radius or forearm fracture sustained during a fall. The patient requires application of a long arm plaster cast to immobilize the elbow and forearm for initial fracture stabilization and pain control. The typical clinical workflow includes evaluation by a clinician (orthopedist, emergency physician, or urgent care provider), radiographic confirmation of fracture alignment, closed reduction if indicated, and application of a long arm plaster cast using supplies billed under Q4005. Post-application instructions include neurovascular checks, cast care, weight-bearing and activity restrictions, and scheduled follow-up for cast check, possible cast change to fiberglass, or definitive operative management if reduction is unstable. Typical sites of service are emergency departments, urgent care centers, orthopedics clinics, and ambulatory surgical centers when performed as part of fracture treatment or stabilization prior to surgery.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no modifier applies; standard billing for the cast supply |
52 |