Other multi-suture craniosynostosis
| Short Descr | Other multi-suture craniosynostosis |
|
Date
|
Action
|
Notes
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|---|---|---|
| 2023-10-01 | Added | Code Added. |
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Code
|
Description
|
|---|---|
| E1800 | Dynamic adjustable elbow extension and flexion device, includes soft interface material |
| E1801 | Static progressive stretch elbow device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories |
| E1802 | Dynamic adjustable forearm pronation/supination device, includes soft interface material |
| E1805 | Dynamic adjustable wrist extension and flexion device, includes soft interface material |
| E1806 | Static progressive stretch wrist device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories |
| E1810 | Dynamic adjustable knee extension and flexion device, includes soft interface material |
| E1811 | Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories |
| E1812 | Dynamic knee, extension/flexion device with active resistance control |
| E1815 | Dynamic adjustable ankle extension and flexion device, includes soft interface material |
| E1816 | Static progressive stretch ankle device, flexion and/or extension, with or without range of motion adjustment, includes all components and accessories |
| E1818 | Static progressive stretch forearm pronation / supination device, with or without range of motion adjustment, includes all components and accessories |
| E1820 | Replacement soft interface material, dynamic adjustable extension/flexion device |
| E1821 | Replacement soft interface material/cuffs for bi-directional static progressive stretch device |
| E1825 | Dynamic adjustable finger extension and flexion device, includes soft interface material |
| E1830 | Dynamic adjustable toe extension and flexion device, includes soft interface material |
| E1831 | Static progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories |
| E1840 | Dynamic adjustable shoulder flexion / abduction / rotation device, includes soft interface material |
| L1000 | Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model |
| L1001 | Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment |
| L1005 | Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment |
| L1010 | Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling |
| L1020 | Addition to ctlso or scoliosis orthosis, kyphosis pad |
| L1025 | Addition to ctlso or scoliosis orthosis, kyphosis pad, floating |
| L1030 | Addition to ctlso or scoliosis orthosis, lumbar bolster pad |
| L1040 | Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad |
| L1060 | Addition to ctlso or scoliosis orthosis, thoracic pad |
| L1070 | Addition to ctlso or scoliosis orthosis, trapezius sling |
| L1080 | Addition to ctlso or scoliosis orthosis, outrigger |
| L1085 | Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions |
| L1090 | Addition to ctlso or scoliosis orthosis, lumbar sling |
| L1100 | Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather |
| L1110 | Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model |
| L1120 | Addition to ctlso, scoliosis orthosis, cover for upright, each |
| L1200 | Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only |
| L1210 | Addition to tlso, (low profile), lateral thoracic extension |
| L1220 | Addition to tlso, (low profile), anterior thoracic extension |
| L1230 | Addition to tlso, (low profile), milwaukee type superstructure |
| L1240 | Addition to tlso, (low profile), lumbar derotation pad |
| L1250 | Addition to tlso, (low profile), anterior asis pad |
| L1260 | Addition to tlso, (low profile), anterior thoracic derotation pad |
| L1270 | Addition to tlso, (low profile), abdominal pad |
| L1280 | Addition to tlso, (low profile), rib gusset (elastic), each |
| L1290 | Addition to tlso, (low profile), lateral trochanteric pad |
| L1300 | Other scoliosis procedure, body jacket molded to patient model |
| L1310 | Other scoliosis procedure, post-operative body jacket |
| L1499 | Spinal orthosis, not otherwise specified |
| L1900 | Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated |
| L1901 | ANKLE ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) [deleted] |
| L1902 | Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
| L1904 | Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated |
| L1906 | Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
| L1907 | Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
| L1910 | Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment |
| L1920 | Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated |
| L1930 | Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
| L1940 | Ankle foot orthosis, plastic or other material, custom fabricated |
| L1945 | Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated |
| L1950 | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated |
| L1951 | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment |
| L1970 | Ankle foot orthosis, plastic with ankle joint, custom fabricated |
| L1971 | Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment |
| L1980 | Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated |
| L1990 | Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated |
| L2000 | Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated |
| L2005 | Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated |
| L2006 | Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated |
| L2010 | Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated |
| L2020 | Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated |
| L2030 | Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated |
| L2034 | Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated |
| L2035 | Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment |
| L2036 | Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated |
| L2037 | Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated |
| L2038 | Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated |
| L3650 | Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
| L3651 | SHOULDER ORTHOSIS, SINGLE SHOULDER, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) [deleted] |
| L3660 | Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
| L3670 | Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
| L3671 | Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3672 | Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may inlcude soft interface, straps, custom fabricated, includes fitting and adjustment [deleted] |
| L3673 | Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, includes nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment [deleted] |
| L3674 | Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3675 | Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf |
| L3677 | Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3678 | Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| L3700 | ELBOW ORTHOSIS, ELASTIC WITH STAYS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3701 | ELBOW ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) [deleted] |
| L3702 | Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3710 | Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf |
| L3720 | Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated |
| L3730 | Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated |
| L3760 | Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3762 | Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf |
| L3763 | Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3764 | Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3765 | Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3766 | Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3800 | WRIST HAND FINGER ORTHOSIS, SHORT OPPONENS, NO ATTACHMENTS, CUSTOM-FABRICATED [deleted] |
| L3805 | WRIST HAND FINGER ORTHOSIS, LONG OPPONENS, NO ATTACHMENT, CUSTOM-FABRICATED [deleted] |
| L3806 | Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment |
| L3808 | Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
| L3809 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
| L3810 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, THUMB ABDUCTION ('C') BAR [deleted] |
| L3820 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, I.P. EXTENSION ASSIST, WITH M.P. EXTENSION STOP [deleted] |
| L3825 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, M.P. EXTENSION STOP [deleted] |
| L3830 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, M.P. EXTENSION ASSIST [deleted] |
| L3840 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, SPRING SWIVEL THUMB [deleted] |
| L3850 | WHO, ADDITION TO SHORT AND LONG OPPONENS, ACTION WRIST, WITH DORSIFLEXION ASSIST [deleted] |
| L3855 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, ADJUSTABLE M.P. FLEXION CONTROL [deleted] |
| L3860 | WHFO, ADDITION TO SHORT AND LONG OPPONENS, ADJUSTABLE M.P. FLEXION CONTROL AND I.P. [deleted] |
| L3890 | ADDITION TO UPPER EXTREMITY JOINT, WRIST OR ELBOW, CONCENTRIC ADJUSTABLE TORSION STYLE MECHANISM, EACH [deleted] |
| L3891 | Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L3900 | Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated |
| L3901 | Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated |
| L3902 | WRIST HAND FINGER ORTHOSIS, EXTERNAL POWERED, COMPRESSED GAS, CUSTOM-FABRICATED [deleted] |
| L3905 | Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3906 | Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3907 | WRIST HAND FINGER ORTHOSIS, WRIST GAUNTLET WITH THUMB SPICA, CUSTOM-FABRICATED [deleted] |
| L3908 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
| L3909 | WRIST ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) [deleted] |
| L3910 | WRIST HAND FINGER ORTHOSIS, SWANSON DESIGN, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3911 | WRIST HAND FINGER ORTHOSIS, ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT (E.G. NEOPRENE, LYCRA) [deleted] |
| L3913 | Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3914 | WRIST HAND ORTHOSIS, WRIST EXTENSION COCK-UP, PREFABRICATED, INCLUDES FITTING/ADJUSTMENT [deleted] |
| L3915 | Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3916 | Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
| L3917 | Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3919 | Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3921 | Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3922 | HAND FINGER ORTHOSIS, KNUCKLE BENDER, TWO SEGMENT TO FLEX JOINTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3923 | Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3924 | Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| L3925 | Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf |
| L3927 | Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf |
| L3928 | HAND FINGER ORTHOSIS, FINGER EXTENSION, WITH CLOCK SPRING, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3929 | Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3930 | Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf |
| L3931 | Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment |
| L3932 | FINGER ORTHOSIS, SAFETY PIN, SPRING WIRE, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3933 | Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3935 | Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3938 | WRIST HAND FINGER ORTHOSIS, DORSAL WRIST, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3940 | WRIST HAND FINGER ORTHOSIS, DORSAL WRIST, WITH OUTRIGGER ATTACHMENT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3944 | HAND FINGER ORTHOSIS, REVERSE KNUCKLE BENDER, WITH OUTRIGGER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3946 | HAND FINGER ORTHOSIS, COMPOSITE ELASTIC, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3948 | FINGER ORTHOSIS, FINGER KNUCKLE BENDER, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3950 | WRIST HAND FINGER ORTHOSIS, COMBINATION OPPENHEIMER, WITH KNUCKLE BENDER AND TWO ATTACHMENTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3952 | WRIST HAND FINGER ORTHOSIS, COMBINATION OPPENHEIMER, WITH REVERSE KNUCKLE AND TWO ATTACHMENTS, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3954 | HAND FINGER ORTHOSIS, SPREADING HAND, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT [deleted] |
| L3956 | Addition of joint to upper extremity orthosis, any material; per joint |
| L3960 | Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
| L3961 | Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3963 | SHOULDER ELBOW WRIST HAND ORTHOSIS, MOLDED SHOULDER, ARM, FOREARM AND WRIST, WITH ARTICULATING ELBOW JOINT, CUSTOM-FABRICATED [deleted] |
| L3964 | Shoulder elbow orthosis, mobile arm support attached to wheelchair, balanced, adjustable, prefabricated, includes fitting and adjustment [deleted] |
| L3965 | Shoulder elbow orthosis, mobile arm support attached to wheelchair, balanced, adjustable rancho type, prefabricated, includes fitting and adjustment [deleted] |
| L3967 | Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3968 | Shoulder elbow orthosis, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints), prefabricated, includes fitting and adjustment [deleted] |
| L3969 | Shoulder elbow orthosis, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support, prefabricated, includes fitting and adjustment [deleted] |
| L3970 | Seo, addition to mobile arm support, elevating proximal arm [deleted] |
| L3971 | Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3972 | Seo, addition to mobile arm support, offset or lateral rocker arm with elastic balance control [deleted] |
| L3973 | Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3974 | Seo, addition to mobile arm support, supinator [deleted] |
| L3975 | Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3976 | Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3977 | Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3978 | Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3980 | Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment |
| L3981 | Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments |
| L3982 | Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment |
| L3984 | Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
| L3985 | UPPER EXTREMITY FRACTURE ORTHOSIS, FOREARM, HAND WITH WRIST HINGE, CUSTOM-FABRICATED [deleted] |
| L3986 | UPPER EXTREMITY FRACTURE ORTHOSIS, COMBINATION OF HUMERAL, RADIUS/ULNAR, WRIST, (EXAMPLE--COLLES' FRACTURE), CUSTOM FABRICATED [deleted] |
| L3995 | Addition to upper extremity orthosis, sock, fracture or equal, each |
| L3999 | Upper limb orthosis, not otherwise specified |
| L4000 | Replace girdle for spinal orthosis (ctlso or so) |
| L4002 | Replacement strap, any orthosis, includes all components, any length, any type |
| L4010 | Replace trilateral socket brim |
| L4020 | Replace quadrilateral socket brim, molded to patient model |
| L4030 | Replace quadrilateral socket brim, custom fitted |
| L4040 | Replace molded thigh lacer, for custom fabricated orthosis only |
| L4045 | Replace non-molded thigh lacer, for custom fabricated orthosis only |
| L4050 | Replace molded calf lacer, for custom fabricated orthosis only |
| L4055 | Replace non-molded calf lacer, for custom fabricated orthosis only |
| L4060 | Replace high roll cuff |
| L4070 | Replace proximal and distal upright for kafo |
| L4080 | Replace metal bands kafo, proximal thigh |
| L4090 | Replace metal bands kafo-afo, calf or distal thigh |
| L4100 | Replace leather cuff kafo, proximal thigh |
| L4110 | Replace leather cuff kafo-afo, calf or distal thigh |
| L4130 | Replace pretibial shell |
| L4210 | Repair of orthotic device, repair or replace minor parts |
| L4360 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L4361 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4370 | Pneumatic full leg splint, prefabricated, off-the-shelf |
| L4380 | Pneumatic knee splint, prefabricated, includes fitting and adjustment [deleted] |
| L4386 | Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L4387 | Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4392 | Replacement, soft interface material, static afo |
| L4394 | Replace soft interface material, foot drop splint |
| L4396 | Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L4397 | Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
| L4398 | Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf |
| No matching codes found | |