Summary & Overview
HCPCS Q4011: Pediatric Short Arm Plaster Cast Supplies
HCPCS Level II code Q4011 denotes cast supplies for a short arm plaster cast specifically for pediatric patients aged 0–10 years. This supply-specific code identifies the materials used to fabricate a short arm cast rather than the professional service of casting application. Nationally, supply codes like Q4011 matter for accurate supply billing, inventory tracking, and appropriate reimbursement for materials provided with pediatric orthopedic care.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for pediatric short arm plaster casts, typical sites of service where the supplies are used, and which payers commonly process claims with this HCPCS Level II code. The publication outlines common modifiers and billing considerations where available, and highlights benchmark and policy topics relevant to supply codes in orthopedic care.
What readers will learn: a clear definition of the code and its clinical role; which major payers cover the code; the typical care settings for use; and which elements are not available in the input (for example, associated taxonomies, ICD-10 diagnoses, and detailed payer-specific payment benchmarks).
Billing Code Overview
HCPCS Level II code Q4011 describes cast supplies, short arm cast, pediatric (0-10 years), plaster. This represents the disposable materials and components used to create a short arm plaster cast for pediatric patients up to 10 years of age.
Service type: Orthopedic casting supply
Typical site of service: Hospital outpatient departments, physician offices, ambulatory surgical centers, urgent care clinics, and other settings where pediatric short arm casting is performed.
Clinical & Coding Specifications
Clinical Context
A 7-year-old child presents to a pediatric urgent care clinic after falling from playground equipment onto an outstretched hand with immediate pain, swelling, and decreased range of motion. Physical exam demonstrates tenderness and deformity of the distal forearm/wrist. Portable radiographs are obtained in the clinic showing a nondisplaced to minimally displaced distal radius fracture. The orthopaedic or urgent care clinician determines nonoperative management is appropriate and applies a short arm plaster cast designed for pediatric patients aged 0–10 years.
The clinical workflow includes triage and pain control, history and focused exam, radiographs for diagnostic confirmation, informed caregiver consent for cast application, measurement and preparation of cast supplies, application of stockinette and padding, placement of plaster layers to form a short arm cast, molding for fracture alignment, patient/caregiver education on cast care and limb elevation, and scheduling of follow-up orthopaedic clinic visit within 1–2 weeks for repeat radiographs and cast check. Documentation includes fracture diagnosis, indication for casting, limb laterality (LT or RT modifier), materials used (plaster short arm cast supplies coded as Q4011), and any complicating factors (e.g., swelling requiring split cast or need for conscious sedation).
Coding Specifications
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