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Official Description

Application of long leg cast brace

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

A long leg cast-brace is a specialized orthopedic device used to immobilize fractures located in the middle or distal femur. This type of cast-brace is designed to provide stability and support to the leg while allowing for some degree of mobility at the knee and hip joints. The construction of the cast-brace involves two main components: a patellar weight-bearing cast that covers the lower leg and an ischial weight-bearing cast that encompasses the thigh. These two sections are connected by external hinges positioned on both the medial and lateral sides of the knee, facilitating movement while maintaining immobilization of the fracture site. The application process begins with the use of a stockinette, which is placed over the entire leg from the thigh down to the toes, followed by padding to ensure comfort and protection. A plaster or fiberglass roll is then prepared by immersing it in water until saturated, after which excess moisture is removed. This material is carefully wrapped around the leg, typically starting from the distal (far) end and moving proximally (toward the body). To enhance the functionality of the cast-brace, plastic sockets are integrated into the upper section of the cast, allowing for the attachment of the external hinges. The plaster or fiberglass is then smoothed and molded to fit the contours of the leg. A critical step in the process involves cutting out the center portion of the cast over the knee, which enables the hinges to be affixed, thus permitting movement at both the knee and hip joints while still providing the necessary support for the healing fracture.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The application of a long leg cast-brace is indicated for the immobilization of fractures specifically located in the middle or distal femur. This procedure is typically performed when there is a need to stabilize the fracture site while allowing for some mobility in the knee and hip joints, which can be crucial for patient comfort and rehabilitation.

  • Fracture of the middle femur This type of fracture occurs in the central portion of the femur and requires immobilization to promote proper healing.
  • Fracture of the distal femur This fracture is located near the knee joint and necessitates a supportive device to maintain alignment and stability during the healing process.

2. Procedure

The procedure for applying a long leg cast-brace involves several detailed steps to ensure proper immobilization and support of the affected leg.

  • Step 1: Preparation of the Leg The first step involves preparing the leg for the cast-brace application. A stockinette is placed over the entire leg, extending from the thigh down to the toes. This serves as a protective layer against the cast material and enhances patient comfort.
  • Step 2: Padding Application Following the stockinette, padding is applied over the stockinette to provide additional cushioning and protection. This step is crucial to prevent skin irritation and pressure sores during the immobilization period.
  • Step 3: Preparation of Plaster or Fiberglass A roll of plaster or fiberglass is then immersed in water to saturate it thoroughly. After soaking, excess water is gently squeezed out to ensure the material is not overly wet, which could affect its setting properties.
  • Step 4: Wrapping the Leg The saturated plaster or fiberglass is wrapped around the leg, typically starting from the distal aspect (the foot) and moving proximally (toward the thigh). This technique helps to ensure a snug fit and proper support for the fracture.
  • Step 5: Incorporation of Plastic Sockets As the cast is being applied, plastic sockets are integrated into the upper portion of the cast. These sockets are essential for the attachment of the external hinges that will allow for mobility at the knee joint.
  • Step 6: Smoothing and Molding Once the cast material is in place, it is smoothed and molded to conform to the shape of the leg. This step is important for both comfort and effectiveness in immobilization.
  • Step 7: Cutting the Knee Portion The final step involves cutting out the center portion of the cast over the knee. This cut-out section allows for the attachment of the hinges, which facilitate movement at both the knee and hip joints while maintaining the necessary support for the fracture.

3. Post-Procedure

After the application of the long leg cast-brace, patients are typically monitored for any signs of complications, such as swelling or discomfort. It is essential to provide instructions regarding care for the cast-brace, including keeping it dry and avoiding any pressure on the cast. Patients may also be advised on mobility restrictions and the importance of follow-up appointments to assess the healing process. The expected recovery time will vary based on the severity of the fracture and the individual patient's healing response.

Short Descr APPLY LONG LEG CAST BRACE
Medium Descr APPLICATION LONG LEG CAST BRACE
Long Descr Application of long leg cast brace
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) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory 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 MPFS nonfacility PE RVUs.
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.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right 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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Pre-1990 Added Code added.
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