Summary & Overview
HCPCS Q4015: Pediatric Plaster Gauntlet Cast Supply
HCPCS Level II code Q4015 denotes a pediatric plaster gauntlet cast supply intended to immobilize the lower forearm and hand for patients aged 0–10 years. As a supply-level code used in outpatient and procedural settings, it is relevant to orthopedic and emergency care lines where casting materials are billed separately from application services.
Key national payers include Aetna, Blue Cross Blue Shield, Cigna, UnitedHealthcare, and Medicare. Readers will find a concise overview of what the code represents, the common clinical contexts for use, typical sites of service, and the payer landscape that influences coverage and billing practices. The publication summarizes benchmarks and policy considerations tied to supply-level HCPCS coding, clarifies where Q4015 fits in pediatric orthopedic workflows, and highlights billing items that commonly accompany cast supplies.
This summary is aimed at billing managers, revenue cycle staff, and clinical leads who need a clear, nationally focused reference for coding and documentation of pediatric plaster gauntlet supplies. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4015 describes cast supplies, gauntlet cast (includes lower forearm and hand), pediatric (0-10 years), plaster. This supply code covers a pediatric gauntlet-style plaster cast designed to immobilize the lower forearm and hand for children up to 10 years of age.
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Service type: Orthopedic cast supply for pediatric immobilization
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Typical site of service: Outpatient clinic, emergency department, ambulatory surgery center, or physician office where cast application or replacement is provided
Clinical & Coding Specifications
Clinical Context
A pediatric patient aged 6 presents to an orthopedic urgent care clinic after falling from playground equipment and sustaining acute forearm pain and swelling. Examination demonstrates tenderness and limited wrist/hand motion. Radiographs confirm a nondisplaced distal radius fracture involving the lower forearm and hand region. The orthopedist decides to apply a pediatric plaster gauntlet cast that immobilizes the lower forearm and hand (gauntlet cast) suitable for ages 0–10. The clinical workflow includes triage and radiography, provider evaluation and informed consent, application of a pediatric plaster gauntlet cast using Q4015 supplies, patient/caregiver education on cast care, scheduling a follow-up visit for repeat radiographs and cast check within 1–2 weeks, and documentation of fracture type, neurovascular status, and cast application details. Typical site of service is an outpatient orthopedic clinic, urgent care clinic, or emergency department pediatric area. Typical service type is durable medical supply for cast materials associated with a physician-applied pediatric plaster gauntlet cast.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work or complexity of casting is substantially greater than typical (extensive swelling, multiple reductions). |