Search all medical codes

Special casting material (e.g., fiberglass)

HCPCS code

Name of the Procedure:

Special Casting Material (A4590)

  • Commonly known as fiberglass casting.
  • Medical term: Special casting material application.


Special casting material, often fiberglass, is used to immobilize and protect broken bones, sprains, or other orthopedic injuries. This type of cast is lighter and more durable than traditional plaster casts.


  • Medical Conditions: Fractures, severe sprains, post-surgical immobilization.
  • Goals: Immobilize and protect the injured area to facilitate proper healing, reduce pain, and prevent further injury.


  • Symptoms/Conditions: Broken bones, severe sprains, post-operative support.
  • Patient Criteria: Appropriate for patients needing long-term immobilization without the weight and bulk of a plaster cast.


  • Pre-Procedure Instructions: No specific preparations like fasting are typically required.
  • Diagnostic Tests: X-rays or other imaging studies to assess the injury.

Procedure Description

  1. Preparation: Skin around the injured area is cleaned and sometimes padded with a soft material.
  2. Application: The special casting material, usually fiberglass, is moistened and wrapped around the injury by a healthcare professional.
  3. Molding: The material is molded to fit the shape of the limb snugly.
  4. Setting: The material sets and hardens within minutes, forming a rigid protective shell.
    • Tools/Equipment: Fiberglass casting material, padding, bandage scissors.
    • Anesthesia: Not typically required; local anesthesia may be used in certain cases for pain management.


  • The application procedure usually takes 20-30 minutes.


  • Performed in various settings such as hospitals, outpatient clinics, or urgent care centers.


  • Involves orthopedic specialists, nurses, and occasionally, radiologic technologists for imaging purposes.

Risks and Complications

  • Common Risks: Skin irritation, itching, swelling under the cast.
  • Rare Risks: Compartment syndrome, cast sores, impaired circulation.
  • Management: Regular monitoring and follow-up visits to check for complications.


  • Expected Benefits: Effective immobilization, improved healing environment, lighter and more durable than plaster.
  • Realization Time: Benefits are typically noticed immediately upon application, with gradual improvement in injury healing over weeks.


  • Post-Procedure Care: Keep the cast dry and clean, avoid putting weight on it unless advised.
  • Recovery Time: Varies based on injury but typically 4-8 weeks.
  • Restrictions: Limited physical activity, follow-up appointments for cast adjustments or removal.


  • Other Options: Plaster casts, removable splints or braces, surgical fixation.
  • Pros and Cons:
    • Plaster Casts: Bulkier and heavier but sometimes necessary for certain types of fractures.
    • Splints/Braces: Removable and more convenient but may not provide as stable immobilization.
    • Surgery: Provides immediate stability and may be necessary for complex fractures but involves higher risk and longer recovery.

Patient Experience

  • During Procedure: Minimal discomfort, sensation of warmth as the material sets.
  • After Procedure: Feeling of tightness, some initial itching. Pain management involves over-the-counter pain relievers; elevate the injured limb to reduce swelling. Comfort measures include avoiding getting the cast wet and keeping it dry.

Note: Always follow the specific recommendations of your healthcare provider.

Similar Codes