Summary & Overview
HCPCS Q4027: Pediatric Hip Spica Cast Supplies, Plaster
HCPCS Level II code Q4027 denotes plaster cast supplies for a pediatric hip spica (one or both legs) for patients aged 0–10 years. This supply code is used in conjunction with clinical casting procedures to immobilize the hip and lower extremities in children following fractures, congenital conditions, or postoperative care. Nationally, accurate coding for pediatric immobilization supplies affects billing clarity, inventory management, and appropriate site-of-service charge capture.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical context for hip spica casting, the typical sites of service where Q4027 applies, and which payers commonly adjudicate claims for these supplies. The publication also outlines expected benchmarks and policy considerations relevant to supply coding, documentation points that support billing, and operational implications for orthopedic and pediatric service lines.
This summary is intended for billing managers, orthopedic clinicians, revenue cycle staff, and policy analysts seeking a national perspective on coding and administrative handling of pediatric hip spica cast supplies under HCPCS Level II code Q4027.
Billing Code Overview
HCPCS Level II code Q4027 describes cast supplies for a hip spica (one or both legs) for pediatric patients (0-10 years), made of plaster. The service type is orthopedic cast supply intended to support immobilization and stabilization of the hip/pelvic region in pediatric patients. The typical site of service is hospital outpatient departments, ambulatory surgical centers, or orthopedic clinics where casting and cast application procedures are performed.
Clinical & Coding Specifications
Clinical Context
A pediatric patient (age 0–10 years) presents to an orthopedic or emergency department after sustaining a proximal femur or pelvic injury, a congenital hip disorder requiring immobilization, or postoperative management following hip surgery. The clinician determines that a hip spica cast is indicated to immobilize one or both lower extremities and the pelvis to promote fracture healing, maintain reduction, or protect surgical fixation. Cast application typically occurs in an operating room, procedure room, or cast room under appropriate analgesia or anesthesia (local, regional, or general) depending on patient age and procedure complexity. The workflow includes clinical evaluation, informed consent, anesthesia as indicated, positioning on a radiolucent table, reduction or alignment as needed (often with fluoroscopic guidance), application of stockinette and padding, placement of plaster or fiberglass layers to form the hip spica, and post-application neurovascular checks and cast care instructions to caregivers. Follow-up visits are scheduled for cast checks, possible trimming or reinforcement, and removal in clinic or procedure suite when healing is sufficient.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Use only if no other modifier applies; not commonly appended in claims. |
22 |