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A hip spica cast is a specialized orthopedic device used to immobilize one or both hips, providing necessary support and stabilization during the healing process. 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 applied to key areas, particularly around the ribs, sacrum, and other pressure points, to prevent discomfort and 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, ensuring that it conforms to the body shape. The cast can be designed to extend only to the knee or all the way to the toes, depending on the specific needs of the patient. 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, it is important to note that CPT® Code 29305 is used for a hip spica cast covering one leg, while CPT® Code 29325 is designated 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 joints. These may include:
The procedure for applying a hip spica cast involves several detailed steps to ensure proper immobilization and support. The process begins with the application of a stockinette, which is a soft, tubular fabric that is placed around the patient's torso, extending down over one or both legs. This stockinette acts as a protective barrier against skin irritation from the cast material. Next, padding is applied over the stockinette, focusing on areas that are prone to pressure, such as the ribs, sacrum, and other bony prominences. This padding is crucial for patient comfort and to prevent the development of pressure sores.
Once the padding is in place, the next step involves preparing the casting material, which can be either plaster or fiberglass. The casting rolls are immersed in water to activate their setting properties, and after soaking, excess water is gently squeezed out to ensure the material is not overly saturated. The saturated casting material is then carefully wrapped around the torso, extending down over one or both legs, depending on the specific requirements of the case. The cast can be designed to stop at the knee or extend all the way to the toes, based on the extent of immobilization needed.
As the casting material begins to set, the healthcare provider will smooth and mold the cast to ensure a snug fit that conforms to the patient's body shape. This step is essential for both comfort and effectiveness in immobilization. Additionally, a bar covered with cast material may be attached between the legs at the thigh level to provide extra support and stability. This bar helps maintain the correct position of the legs and enhances the overall effectiveness of the hip spica cast.
After the application of the hip spica cast, post-procedure care is critical to ensure proper healing and patient comfort. The patient should be monitored for any signs of discomfort or complications, such as skin irritation or pressure sores, particularly in areas where padding was applied. It is important to keep the cast dry and intact, as moisture can compromise the integrity of the cast material and lead to skin issues. Patients may require assistance with mobility, as the cast significantly limits movement. Follow-up appointments are essential to assess the healing process and to make any necessary adjustments to the cast. In some cases, the cast may need to be replaced or modified as the patient's condition improves or changes. Proper education on care and monitoring for complications should be provided to the patient and caregivers to ensure a successful recovery.
| Short Descr | APPLICATION OF HIP CASTS | Medium Descr | APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS | Long Descr | Application of hip spica cast; 1 and one-half spica or both legs | 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). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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