Q4042 — Cast supplies, long leg splint, adult (11 years +), fiberglass
Q4042 is a HCPCS Level II code for cast supplies, long leg splint, adult (11 years +), fiberglass. It belongs to the Temporary Codes section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Physician fee schedule statusX
Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.
Global period: XXX
Want the dollar amount for your locality? The fee calculator applies your GPCI and the current conversion factor.
Medically Unlikely Edits — units per day
The most units of Q4042 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Clinical: Data
- DME supplier
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for Q4042
- Long descriptor
- Cast supplies, long leg splint, adult (11 years +), fiberglass
- Short descriptor
- Cast sup lng leg splnt fbrgl
- Added
- July 1, 2001
- BETOS
- D1A
- Pricing indicator
- 55 — Other
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Splints and casts, effective 1 October 2014.
Codes adjacent to Q4042
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If Q4042 is not quite right, the correct code is very often within a few positions of it.
- Q4034Cast supplies, long leg cylinder cast, adult (11 years +), fiberglass
- Q4035Cast supplies, long leg cylinder cast, pediatric (0-10 years), plaster
- Q4036Cast supplies, long leg cylinder cast, pediatric (0-10 years), fiberglass
- Q4037Cast supplies, short leg cast, adult (11 years +), plaster
- Q4038Cast supplies, short leg cast, adult (11 years +), fiberglass
- Q4039Cast supplies, short leg cast, pediatric (0-10 years), plaster
- Q4040Cast supplies, short leg cast, pediatric (0-10 years), fiberglass
- Q4041Cast supplies, long leg splint, adult (11 years +), plaster
- Q4043Cast supplies, long leg splint, pediatric (0-10 years), plaster
- Q4044Cast supplies, long leg splint, pediatric (0-10 years), fiberglass
- Q4045Cast supplies, short leg splint, adult (11 years +), plaster
- Q4046Cast supplies, short leg splint, adult (11 years +), fiberglass
- Q4047Cast supplies, short leg splint, pediatric (0-10 years), plaster
- Q4048Cast supplies, short leg splint, pediatric (0-10 years), fiberglass
- Q4049Finger splint, static
- Q4050Cast supplies, for unlisted types and materials of casts
Questions about Q4042
What is HCPCS code Q4042?
Q4042 is a HCPCS Level II code for cast supplies, long leg splint, adult (11 years +), fiberglass. It sits in the Temporary Codes section.
Does Medicare cover Q4042?
The CMS HCPCS file marks Q4042 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
How is Q4042 paid under the physician fee schedule?
Q4042 carries PFS status code X. Statutory exclusion. The item or service is not within the statutory definition of 'physician services', so the fee schedule never pays it.