Summary & Overview
HCPCS Q4025: Adult Hip Spica Cast Supplies, Plaster
HCPCS Level II code Q4025 denotes plaster cast supplies for an adult hip spica (one or both legs). The code identifies materials used to fabricate a full hip spica cast for patients aged 11 years and older and is important for accurate billing of immobilization services in orthopedic and post-operative care. Nationally, correct use of this HCPCS Level II code supports appropriate supply reimbursement and clear claims documentation for procedures requiring extensive lower-extremity immobilization.
Key payers in this analysis 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, along with guidance on what types of benchmarks and policy topics are commonly reviewed for supply codes such as Q4025: coverage policies, coding and billing requirements, claim adjudication considerations, and typical place-of-service patterns. The report also outlines common modifiers and payer-specific documentation expectations where available.
Where specific data elements were not provided in the input, the summary notes that those items are not available. The content is intended for national audiences involved in medical billing, revenue cycle management, and clinical services that utilize hip spica casting supplies.
Billing Code Overview
HCPCS Level II code Q4025 describes cast supplies for a hip spica (one or both legs), adult (11 years +), plaster. This item represents the disposable materials used to construct a full hip spica cast for adult patients, typically employed in immobilization after fractures, corrective procedures or when prolonged stabilization of the hip and proximal femur is required.
Service type: Durable medical supply / cast application materials
Typical site of service: Hospital inpatient, hospital outpatient, ambulatory surgery center, or orthopedic clinic where casting or immobilization procedures are performed. If specific payer or procedural contexts are required, Data not available in the input.
Clinical & Coding Specifications
Clinical Context
An adult patient (age ≥11 years) presents to an orthopedic clinic or hospital ambulatory procedure area after sustaining a femoral fracture, acetabular fracture, complex pelvic injury, or following hip surgery requiring immobilization of one or both lower extremities. The clinician evaluates the patient, documents the reason for immobilization, and determines that a hip spica cast using plaster is indicated for definitive immobilization or temporary stabilization. A cast technician or orthopedist applies the Q4025 cast supplies (hip spica, adult, plaster) during the procedure. Typical workflow: patient evaluation and informed consent → pre-cast neurovascular exam and measurements → application of padding, stockinette, and plaster hip spica components using Q4025 supplied materials → post-application neurovascular check and cast care instructions. Typical sites of service include the orthopedic clinic, ambulatory surgery center, emergency department, or inpatient hospital unit depending on acuity and concurrent procedures.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When application requires substantially greater work than typical (e.g., complex revision casting after debridement). |