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Official Description

Application, cast; shoulder spica

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A shoulder spica cast is a specialized type of cast designed to immobilize the shoulder, arm, and torso, providing support and stability to the affected area. This cast is particularly useful in cases of fractures, dislocations, or post-surgical recovery involving the shoulder joint. The application of a shoulder spica cast involves several steps to ensure proper fit and function. Initially, a stockinette is placed over the torso and the injured shoulder and arm to protect the skin. Following this, padding is applied to provide cushioning and prevent pressure sores. The casting process involves the use of plaster or fiberglass material, which is first immersed in water to activate its setting properties. Once the excess water is removed, the material is carefully wrapped around the torso, shoulder, and arm, ensuring that it conforms to the contours of the body. As the casting material begins to harden, it is smoothed and molded to achieve a secure and comfortable fit. This immobilization is crucial for the healing process, as it restricts movement and allows for proper alignment of the bones and soft tissues during recovery.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The shoulder spica cast is indicated for various conditions that require immobilization of the shoulder and arm. These include:

  • Fractures of the shoulder or upper arm that necessitate stabilization to promote healing.
  • Dislocations of the shoulder joint that require immobilization to prevent further injury.
  • Post-surgical recovery following procedures involving the shoulder or upper arm, where immobilization is essential for proper healing.

2. Procedure

The application of a shoulder spica cast involves several detailed steps to ensure effective immobilization and comfort for the patient.

  • Step 1: Preparation - The patient is positioned comfortably, and the area around the shoulder and arm is cleaned to ensure proper adhesion of the casting materials. A stockinette is then applied over the torso, shoulder, and arm to protect the skin from irritation and to provide a base for the padding.
  • Step 2: Padding Application - Soft padding is placed over the stockinette to provide cushioning. This padding is crucial as it helps to prevent pressure sores and discomfort once the cast is applied. Care is taken to ensure that the padding is evenly distributed and covers all areas that will be encased in the cast.
  • Step 3: Casting Material Preparation - A roll of plaster or fiberglass is immersed in water to activate its setting properties. The material is saturated thoroughly, and any excess water is gently squeezed out to ensure that it is not overly wet, which could affect the setting process.
  • Step 4: Application of the Cast - The saturated plaster or fiberglass is then wrapped around the torso, shoulder, and arm. The application is done in layers, ensuring that the material conforms to the contours of the body for a secure fit. Care is taken to avoid any gaps or areas where the cast may be too tight.
  • Step 5: Molding and Smoothing - As the casting material begins to set, the healthcare provider smooths and molds it to ensure comfort and proper alignment. This step is critical as it helps to create a well-fitted cast that will effectively immobilize the shoulder and arm.

3. Post-Procedure

After the application of the shoulder spica cast, the patient is monitored for any signs of discomfort or complications. It is important to provide instructions on how to care for the cast, including keeping it dry and avoiding any pressure on the casted area. The patient may be advised on pain management strategies and the importance of follow-up appointments to assess healing and make any necessary adjustments to the cast. The expected recovery time will vary depending on the underlying condition being treated, and the healthcare provider will provide guidance on activity restrictions during the healing process.

Short Descr APPLICATION OF SHOULDER CAST
Medium Descr APPLICATION CAST SHOULDER SPICA
Long Descr Application, cast; shoulder spica
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Procedure or Service, Multiple Reduction Applies
ASC Payment Indicator Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P6B - Minor procedures - musculoskeletal
MUE 1
CCS Clinical Classification 214 - Traction, splints, and other wound care
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
LT Left side (used to identify procedures performed on the left side of the body)
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
RT Right side (used to identify procedures performed on the right side of the body)
Date
Action
Notes
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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