Summary & Overview
HCPCS Level II Q4042: Long Leg Fiberglass Splint, Adult (11+)
HCPCS Level II code Q4042 identifies a fiberglass long leg splint intended for adults and older adolescents (11 years and above). As a supply-centered code, it covers the physical material used to immobilize the lower extremity—commonly applied in emergency departments, outpatient orthopedic clinics, and ambulatory surgical settings for fractures, soft-tissue injuries, or post-operative stabilization. Nationally, standardized codes like Q4042 help align coverage definitions, billing practices, and supply management across payers and care sites. Key payers in this context include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. This publication provides a concise briefing on what the code represents, payer coverage considerations, and clinical context for use. Readers will find benchmarks on typical use and reimbursement patterns where available, a summary of common billing modifiers and coding relationships, and practical notes on appropriate service lines and sites of service. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code Q4042 describes cast supplies, long leg splint, adult (11 years +), fiberglass. This supply-level code represents a preformed or custom cast component intended to immobilize the lower extremity from the thigh or knee to the foot for adult patients and older adolescents. The service type is durable medical supply for immobilization of the lower limb. The typical site of service includes outpatient clinics, emergency departments, ambulatory surgery centers, and other settings where splinting or casting is applied for acute injuries or post-operative care.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
An adult patient (age ≥ 11 years) presents to an orthopedic clinic or emergency department with an acute lower-extremity injury requiring immobilization. Common presentations include a closed tibial shaft fracture, distal femur fracture, severe soft-tissue injury of the knee or leg, or as a temporary immobilization for a suspected fracture pending definitive imaging. The clinician evaluates the patient, documents history and physical exam, obtains indicated radiographs, and determines that a temporary or definitive long leg splint is appropriate. The facility or clinician supplies a Q4042 long leg fiberglass splint (adult). The workflow typically includes triage and assessment, imaging, reduction if indicated, application of the fiberglass long leg splint by orthopedics or emergency staff, patient education on weight-bearing status and wound care, and arrangement for follow-up with orthopedics for definitive management or cast/splint removal or conversion. Typical sites of service are the emergency department, ambulatory orthopedics clinic, urgent care center, or outpatient orthopedic procedure room.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Use when the splint is applied to the left lower extremity. |