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Official Description

Application of hip spica cast; 1 leg

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

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.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

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:

  • Fractures of the femur - A hip spica cast is often used to stabilize fractures in the femur, particularly in pediatric patients, to ensure proper alignment during the healing process.
  • Hip dislocations - In cases of hip dislocation, immobilization is crucial to prevent further injury and allow for proper healing.
  • Post-surgical stabilization - Following certain surgical procedures involving the hip or femur, a hip spica cast may be applied to maintain stability and support recovery.
  • Severe soft tissue injuries - Injuries to the soft tissues around the hip may necessitate immobilization to promote healing and prevent further damage.

2. Procedure

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.

  • Step 1: Preparation - The patient is positioned comfortably, and the area around the hip and leg is cleaned and assessed for any existing injuries. A stockinette is then selected based on the size of the patient.
  • Step 2: Application of Stockinette - The stockinette is applied starting at the ribs and extending down over one leg. This provides a protective layer against the cast material.
  • Step 3: Padding - Soft padding is placed over the stockinette, focusing on areas that are prone to pressure, such as the ribs, sacrum, and other bony prominences. This padding is essential for patient comfort and to prevent skin irritation.
  • Step 4: Preparation of Casting Material - A roll of plaster or fiberglass is immersed in water until fully saturated. Excess water is gently squeezed out to ensure the material is not overly wet.
  • Step 5: Application of Cast - The saturated plaster or fiberglass is wrapped around the torso and extended over the leg, ensuring that it covers the necessary areas for immobilization. The cast may be molded to extend only to the knee or all the way to the toes, depending on the clinical requirements.
  • Step 6: Molding and Smoothing - As the casting material begins to set, the healthcare provider smooths and molds the cast to ensure a snug fit, which is crucial for effective immobilization.
  • Step 7: Additional Support - If necessary, a bar covered with cast material may be attached between the legs at the thigh level to provide additional support and stability.

3. Post-Procedure

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
Date
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Notes
2010-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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