Summary & Overview
HCPCS Q4035: Pediatric Long Leg Cylinder Plaster Cast Supply
HCPCS Level II code Q4035 identifies the supply component for a pediatric long leg cylinder plaster cast (ages 0–10). This code is used when documenting and billing the cast supplies separate from professional application or clinical services. Nationally, accurate use of supply codes like Q4035 matters for proper reimbursement, inventory tracking, and care coordination in pediatric orthopedic care.
Key payers covered in this review include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical context, typical sites of service, and the types of billing scenarios where the supply-only code applies. The publication outlines common modifiers associated with supply and durable medical equipment billing (listed separately), and notes areas where policy variations among major payers may affect coverage and payment processes.
This summary provides benchmarks and policy-relevant points for billing teams and revenue cycle managers, along with clinical context to support correct coding when supplying a pediatric plaster long leg cylinder cast. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4035 describes cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster. The code represents the supply component for application of a long leg cylinder plaster cast for pediatric patients up to 10 years of age.
Service Type: Cast supply / orthopedic immobilization supply
Typical Site of Service: Hospital outpatient, ambulatory surgery center, orthopedic clinic, emergency department
Clinical & Coding Specifications
Clinical Context
A 7-year-old child presents to the pediatric orthopedics clinic after a fall from playground equipment with acute pain, swelling, and inability to bear weight on the affected leg. Radiographs confirm a non-displaced distal femur fracture requiring immobilization. The clinician elects application of a long leg cylinder plaster cast sized for a pediatric patient (age 0–10 years). Clinical workflow: assessment and imaging in clinic or emergency department; informed consent from guardian; selection and preparation of Q4035 cast supplies; application of soft padding and stockinette, molding and placement of plaster rolls to form a long leg cylinder cast extending from groin to toes; drying time and cast care instructions provided to caregiver; follow-up arranged in 1–2 weeks for cast check and repeat imaging; conversion to walking cast or cast removal based on healing progress.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified | Rarely used; only when no other modifier applies and payer requires a default code |
11 | Administrative use — default for no special circumstances |