Summary & Overview
HCPCS Q4043: Cast Supplies, Pediatric Long Leg Plaster Splint
HCPCS Level II code Q4043 represents a pediatric long leg plaster splint supply used for immobilization of the lower extremity in children aged 0–10 years. As a supply-level HCPCS code, it identifies a specific disposable cast product rather than a professional procedure. Nationally, accurate coding of supply items like Q4043 affects supply-chain billing, claims categorization, and aggregated pediatric orthopedic utilization metrics.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context, typical sites of service, and common billing modifiers associated with supply lines. The publication provides benchmarks and comparative notes on payer coverage tendencies, billing scenarios where Q4043 appears, and policy considerations relevant to supply coding and reimbursement recognition.
This summary equips billing managers, revenue cycle staff, and clinical administrators with the context needed to classify Q4043 appropriately on supply service lines, interpret payer expectations, and align documentation for pediatric immobilization care. Data not available in the input are clearly marked in the detailed sections.
Billing Code Overview
HCPCS Level II code Q4043 designates cast supplies, long leg splint, pediatric (0-10 years), plaster. This item is a disposable or single-use cast supply intended for immobilization of the lower extremity in pediatric patients up to 10 years of age.
Service type: Orthopedic immobilization supply
Typical site of service: Ambulatory clinic, emergency department, orthopedics office, or urgent care setting
Clinical & Coding Specifications
Clinical Context
A 7-year-old child presents to the pediatric orthopedic clinic after a fall from a bicycle with pain, swelling, and inability to bear weight on the lower extremity. Imaging (radiograph) confirms a distal tibia/fibula fracture without significant displacement. The orthopedic clinician applies a Q4043 cast supply (long leg splint, pediatric 0–10 years, plaster) in the clinic to immobilize the limb temporarily while edema decreases and definitive casting or further management is arranged.
The clinical workflow: the patient is triaged, history and focused exam are performed, radiographs obtained and reviewed, informed consent for splinting is obtained from the parent/guardian, analgesia and local wound care if needed are provided, and the clinician selects appropriate pediatric long leg splint supplies. The splint is formed with plaster materials, molded to proper alignment, soft padding applied to pressure points, and the limb is positioned in neutral alignment. Post-application instructions and follow-up appointment for re-evaluation and possible conversion to a circumferential cast or orthopedic follow-up are documented. Supply itemization uses Q4043 for the pediatric plaster long leg splint supplies (0–10 years).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 |