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    v1.0.28
    OpenPayerBilling CodesTemporary CodesHCPCS hcpcs-q4021-short-arm-plaster-splint-adult
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    HCPCS Level II Q4021: Short Arm Plaster Splint, Adult

    HCPCS Level II code Q4021 describes cast supplies for a short arm plaster splint intended for adult patients (11 years and older); the service is supply of a ready-made or prefabricated short arm splint made of plaster used to immobilize the forearm/wrist, typically provided in ambulatory clinic or emergency department settings as a durable medical supply for acute injuries or immediate immobilization.

    For related coverage guidance, see recent payer policy updates: B-Hemolytic Streptococcus Testing, Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance Assays, Hepatitis Testing (A, B, C, D) Coverage Criteria.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old adult presents to an urgent care clinic after a fall onto an outstretched hand while playing recreational sports. The patient reports acute wrist pain, swelling, and limited range of motion. Point-of-care radiographs performed in clinic demonstrate a non-displaced distal radius fracture. The treating clinician elects to immobilize the wrist with a short arm plaster splint for initial management and pain control prior to orthopedic follow-up.

    The clinical workflow: triage and brief history/physical, focused musculoskeletal exam, wound check (if applicable), obtain and review wrist radiographs, discuss treatment options and obtain informed consent for splinting, apply Q4021 cast supplies (short arm splint, adult, plaster) with appropriate padding and plaster splint material, provide patient education on splint care and signs of complications, schedule follow-up with orthopedics within 7–10 days for re-evaluation and possible conversion to a definitive cast or operative planning. Supplies are documented in the procedure note and billed using the Q4021 HCPCS Level II code along with the relevant evaluation and management or procedural codes as appropriate.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29260Application of short arm splint (forearm to hand); staticOften performed in conjunction with Q4021 when a clinician applies a short arm splint as the primary immobilization procedure
    73630Radiologic examination, forearm; complete, minimum of 3 viewsPre- or post-splint radiographs to evaluate fracture alignment prior to or after splint application
    99203Office or other outpatient visit for the evaluation and management of a new patient, low to moderate complexity (CPT example)E/M service commonly billed for the initial assessment and decision to apply a short arm splint in clinic (select appropriate level per documentation)
    29125Application of short arm cast; below elbow to hand, staticUsed when the temporary plaster splint is converted to a full circumferential cast after swelling subsides; complements Q4021 when definitive casting is performed
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visit or procedureSometimes used for additional non-cast supply items; documentation should justify bundling vs use of Q4021 for the specific cast supplies

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RA0000XAdolescent Medicine (Internal Medicine) PhysicianAn internist who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and so…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    367500000XCertified Registered Nurse Anesthetist(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, prov…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    344600000XTaxiA land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set f…
    207QP0002XPhysician Nutrition Specialist (Family Medicine)A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…
    170100000XPh.D. Medical GeneticsA medical geneticist works in association with a medical specialist, is affiliated with a clinical genetics program, and serves as a consultant to med…

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    M25.521Pain in right elbow
    M25.522Pain in left elbow
    M75.121Complete rotator cuff tear or rupture of right shoulder, not specified as traumatic
    M75.122Complete rotator cuff tear or rupture of left shoulder, not specified as traumatic
    M76.61Achilles tendinitis, right leg
    M79.621Pain in right upper arm
    M79.622Pain in left upper arm
    S42.201AUnspecified fracture of upper end of right humerus, initial encounter for closed fracture
    S42.201BUnspecified fracture of upper end of right humerus, initial encounter for open fracture
    S42.202AUnspecified fracture of upper end of left humerus, initial encounter for closed fracture

    Showing 1–10 of 27

    Related Payer Policy Updates

    Specialty: Infectious Disease1 / 3

    9 rows

    PolicyPayerEffective Date
    B-Hemolytic Streptococcus TestingOscar Health2026-10-01
    Human Immunodeficiency Virus (HIV) — Coverage Criteria for Testing and Resistance AssaysOscar Health2026-10-01
    Hepatitis Testing (A, B, C, D) Coverage CriteriaOscar Health2026-10-01
    Lyme Disease Testing Coverage CriteriaOscar Health2026-10-01
    Pathogen Panel TestingOscar Health2026-10-01
    Diagnostic Testing of Common Sexually Transmitted InfectionsOscar Health2026-10-01
    Testing for Vector-Borne InfectionsOscar Health2026-10-01
    Coronavirus Testing in the Outpatient SettingOscar Health2026-10-01
    Testing for Diagnosis of Active or Latent TuberculosisOscar Health2026-10-01

    Related Codes

    HCPCS-LEVEL-II-Q4139-INJECTABLE-AMNIOMATRIX-BIODMATRIX-1-CC

    HCPCS Q4139: Amniomatrix or Biodmatrix, Injectable, 1 cc

    HCPCS-LEVEL-II-Q4256-AREA-BASED-PROCEDURAL-ADD-ON-PER-SQ-CM

    HCPCS Q4256: MLG-complete Skin Graft Material, Per Sq Cm

    HCPCS-LEVEL-II-Q5132-ADALIMUMAB-AFZB-ABRILADA-10MG-INJECTION

    HCPCS Level II Q5132: Injection, adalimumab-afzb (Abrilada), 10 mg

    HCPCS-Q0035-CARDIOKYMOGRAPHY-CARDIAC-MOTION-RECORDING

    HCPCS Level II Q0035: Cardiokymography

    HCPCS-Q0081-INFUSION-THERAPY-NON-CHEMOTHERAPEUTIC-PER-VISIT

    HCPCS Level II Q0081: Infusion Therapy, Non‑Chemotherapeutic, Per Visit

    HCPCS-Q0083-CHEMOTHERAPY-NON-INFUSION-ADMINISTRATION

    HCPCS Q0083: Chemotherapy Administration, Non-Infusion Methods

    HCPCS-Q0084-CHEMOTHERAPY-INFUSION-ADMINISTRATION-PER-VISIT

    HCPCS Q0084: Chemotherapy Infusion Administration, Per Visit

    HCPCS-Q0085-CHEMOTHERAPY-INFUSION-PLUS-OTHER-TECHNIQUES-PER-VISIT

    HCPCS Q0085: Chemotherapy Infusion Plus Other Technique(s), Per Visit

    HCPCS-Q0091-PAP-SMEAR-SPECIMEN-COLLECTION-TRANSPORT

    HCPCS Q0091: Screening Papanicolaou Smear Collection and Transport

    HCPCS-Q0092-PORTABLE-XRAY-EQUIPMENT-SETUP

    HCPCS Q0092: Set-up Portable X-ray Equipment

    Showing 1–10 of 629

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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