Summary & Overview
HCPCS Q4039: Pediatric Short Leg Plaster Cast Supplies
HCPCS Level II code Q4039 denotes pediatric short leg plaster cast supplies for children aged 0–10 and identifies the material components used in pediatric lower-extremity immobilization. This supply-level code matters nationally because it affects billing for common pediatric orthopedic procedures performed in emergency departments, outpatient clinics, and ambulatory surgery centers. Accurate use of Q4039 supports appropriate supply reimbursement and clearer claims adjudication for pediatric casts.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines what providers and revenue-cycle teams need to know about code definition, typical sites of service, and the clinical context for pediatric casting. Readers will find benchmarks for how this supply code is used relative to common service lines, summaries of payer coverage scope where available, and notes on coding practice considerations when supplies are billed separately.
The piece also provides concise clinical context for when a short leg plaster cast is selected for children, and flags where input data was not provided for related taxonomies, diagnosis mappings, or payer-specific policy language. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4039 describes cast supplies: short leg cast for pediatric patients (ages 0-10), plaster. This itemized supply code covers the materials used to apply a short leg plaster cast for children and is typically billed when the cast components are provided as part of orthopedic immobilization.
Service Type: Orthopedic supply for pediatric immobilization
Typical Site of Service: Outpatient orthopedic clinic, emergency department, ambulatory surgery center, or other outpatient setting where pediatric casting is performed.
Clinical & Coding Specifications
Clinical Context
A 7-year-old child presents to a pediatric orthopedic clinic after falling from playground equipment and complaining of ankle pain and inability to bear weight. Physical exam demonstrates swelling, point tenderness over the distal fibula, and limited range of motion. Plain radiographs confirm a nondisplaced distal fibular fracture without neurovascular compromise. The orthopedic technician and provider apply a short leg plaster cast to immobilize the lower leg while the fracture is stable and healing is expected to be uncomplicated. The typical workflow: triage and history, focused musculoskeletal exam, radiographic evaluation, informed consent obtained from parent/guardian, procedural preparation (analgesia as needed, positioning), application of cast supplies for a pediatric short leg plaster cast (Q4039), patient/caregiver education on cast care, scheduling of follow-up clinic visit for repeat radiographs and cast removal or change, and documentation of diagnosis, procedure, materials used, and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the short leg cast is applied to the left lower extremity |
RT |