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A hip spica cast is a specialized orthopedic device designed to immobilize one or both hips, providing essential support during the healing process of certain injuries or conditions affecting the hip area. The application of this cast begins with the placement of a stockinette, which is a soft, tubular fabric that is wrapped around the patient's torso, extending down over one or both legs. This stockinette serves as a protective layer against skin irritation from the cast material. Following the stockinette, padding is strategically placed to cushion the areas around the ribs, sacrum, and other pressure points, ensuring comfort and reducing the risk of pressure sores. The next step involves the use of plaster or fiberglass rolls, which are first immersed in water to activate their setting properties. After excess water is squeezed out, the saturated material is carefully wrapped around the torso and legs, forming the cast. Depending on the specific requirements of the patient's condition, the cast may extend only to the knee or all the way to the toes. As the casting material begins to set, it is smoothed and molded to ensure a snug fit. Additionally, a bar covered with cast material may be attached between the legs at the thigh level to enhance stability and support. For coding purposes, the appropriate CPT® code for a hip spica cast covering one leg is 29305, while 29325 is used for a hip spica cast that covers one leg and half of the other or both legs.
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The application of a hip spica cast is indicated for various conditions that require immobilization of the hip joint and surrounding structures. These indications may include:
The procedure for applying a hip spica cast involves several detailed steps to ensure proper immobilization and support. Each step is critical for the effectiveness of the cast.
After the application of the hip spica cast, the patient will require specific post-procedure care to ensure proper healing and comfort. The cast should be monitored for any signs of complications, such as increased pain, swelling, or skin irritation. Patients are typically advised to keep the cast dry and avoid submerging it in water. Follow-up appointments are essential to assess the healing process and make any necessary adjustments to the cast. Patients may also receive instructions on mobility and weight-bearing restrictions, depending on their individual condition and the extent of immobilization required.
| Short Descr | APPLICATION OF HIP CAST | Medium Descr | APPLICATION HIP SPICA CAST 1 LEG | Long Descr | Application of hip spica cast; 1 leg | 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 |
| 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. | 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) | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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