Summary & Overview
HCPCS Q4017: Long Arm Plaster Splint, Adult (11+)
HCPCS Level II code Q4017 represents the supply item for a long arm plaster splint for adults (age 11+). This code is used to bill for the plaster splint material itself, typically supplied when immobilizing the forearm and elbow after injury or procedure. Nationally, supply codes such as Q4017 matter because they influence facility and professional billing for common orthopedic immobilization needs and factor into overall episode costs for musculoskeletal care.
Key payers relevant to this code include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context and typical sites of service, plus guidance on what types of benchmarks and policy items to examine when evaluating use of Q4017. The publication covers expected reimbursement considerations, coding interactions with procedure and supply lines, and typical documentation elements that support billing. It also identifies where data is available and where input was not provided: associated taxonomies, ICD-10 diagnoses, related codes, and detailed payer-specific coverage rules are not included in the input.
This summary is intended for billing managers, revenue cycle professionals, clinical staff involved in orthopedics and urgent care, and policy analysts seeking a national-level briefing on the code and its role in immobilization supply billing.
Billing Code Overview
HCPCS Level II code Q4017 describes cast supplies, long arm splint, adult (11 years +), plaster. This code denotes the supply item used to create or support a long arm plaster splint for patients aged 11 years and older. The service type is supply of orthopedic immobilization materials for upper extremity injuries or post-procedural support. The typical site of service is ambulatory clinics, emergency departments, outpatient orthopedics or urgent care settings where splints are applied or replaced.
Clinical & Coding Specifications
Clinical Context
An adult patient (age ≥ 11 years) presents to an urgent care or orthopedic clinic after a fall onto an outstretched hand with acute forearm or wrist pain, visible deformity, and limited wrist/elbow motion. Imaging (plain radiographs) demonstrates an isolated distal radius fracture or a nondisplaced/unstable forearm/forearm metaphyseal fracture requiring immobilization. The clinician determines a long arm splint is appropriate for initial stabilization and comfort prior to definitive casting or further surgical planning.
The clinical workflow: the patient is triaged, history and focused physical exam are performed, radiographs are obtained and reviewed, informed consent is documented, neurovascular status is recorded pre- and post-application, and a long arm plaster splint is applied to immobilize the forearm and elbow. The provider documents splint type Q4017 (long arm splint, adult, plaster), time of application, materials used, laterality, and any modifiers as appropriate. Follow-up instructions and a re-evaluation plan (orthopedic follow-up in 1–2 weeks) are provided. Typical sites of service include outpatient orthopedic clinics, urgent care centers, emergency departments, and ambulatory surgery centers for temporary immobilization prior to definitive management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the splint is applied to the left upper extremity |