Medical Billing Code Search
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9172 results found
| L0484 | Tlso rigid plastic cust fab | Description: Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated |
| L0486 | Tlso rigidlined cust fab two | Description: Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated |
| L0488 | Tlso rigid lined pre one pie | Description: Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment |
| L0490 | Tlso rigid plastic pre one | Description: Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment |
| L0491 | Tlso 2 piece rigid shell | Description: Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment |
| L0492 | Tlso 3 piece rigid shell | Description: Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment |
| L0621 | Sio flex pelvic/sacr pre ots | Description: Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
| L0622 | Sio flex pelvisacral custom | Description: Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated |
| L0623 | Sio rig pnl pelv/sac pre ots | Description: Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
| L0624 | Sio panel custom | Description: Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated |
| L0625 | Lo flex l1-below l5 pre ots | Description: Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf |
| L0626 | Lo sag rig pnl stays pre cst | Description: Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0627 | Lo sag ri an/pos pnl pre cst | Description: Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0628 | Lso flex no ri stays pre ots | Description: Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0629 | Lso flex w/rigid stays cust | Description: Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated |
| L0630 | Lso r post pnl sj-t9 pre cst | Description: Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0631 | Lso sag r an/pos pnl pre cst | Description: Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0632 | Lso sag rigid frame cust | Description: Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated |
| L0633 | Lso sc r pos/lat pnl pre cst | Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0634 | Lso flexion control custom | Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated |
| L0635 | Lso sagit rigid panel prefab | Description: Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment |
| L0636 | Lso sagittal rigid panel cus | Description: Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated |
| L0637 | Lso sc r ant/pos pnl pre cst | Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0638 | Lso sag-coronal panel custom | Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated |
| L0639 | Lso s/c shell/panel prefab | Description: Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0640 | Lso s/c shell/panel custom | Description: Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated |
| L0641 | Lo rig pos pnl l1-l5 pre ots | Description: Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0642 | Lo sag ri an/pos pnl pre ots | Description: Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0643 | Lso sag ctr rigi pos pre ots | Description: Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0648 | Lso sag r an/pos pnl pre ots | Description: Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0649 | Lso sc r pos/lat pnl pre ots | Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0650 | Lso sc r ant/pos pnl pre ots | Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
| L0651 | Lso sag-co shell pnl pre ots | Description: Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf |
| L0700 | Ctlso a-p-l control molded | Description: Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type) |
| L0710 | Ctlso a-p-l control w/ inter | Description: Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type) |
| L0720 | Ctlso a-p-l control custom | Description: Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L0810 | Halo cervical into jckt vest | Description: Halo procedure, cervical halo incorporated into jacket vest |
| L0820 | Halo cervical into body jack | Description: Halo procedure, cervical halo incorporated into plaster body jacket |
| L0830 | Halo cerv into milwaukee typ | Description: Halo procedure, cervical halo incorporated into milwaukee type orthosis |
| L0859 | Mri compatible system | Description: Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material |
| L0861 | Halo repl liner/interface | Description: Addition to halo procedure, replacement liner/interface material |
| L0970 | Tlso corset front | Description: Tlso, corset front |
| L0972 | Lso corset front | Description: Lso, corset front |
| L0974 | Tlso full corset | Description: Tlso, full corset |
| L0976 | Lso full corset | Description: Lso, full corset |
| L0978 | Axillary crutch extension | Description: Axillary crutch extension |
| L0980 | Peroneal straps pair pre ots | Description: Peroneal straps, prefabricated, off-the-shelf, pair |
| L0982 | Stocking sup grips 4 pre ots | Description: Stocking supporter grips, prefabricated, off-the-shelf, set of four (4) |
| L0984 | Protect body sock ea pre ots | Description: Protective body sock, prefabricated, off-the-shelf, each |
| L0999 | Add to spinal orthosis nos | Description: Addition to spinal orthosis, not otherwise specified |
| L1000 | Ctlso milwauke initial model | Description: Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model |
| L1001 | Ctlso infant immobilizer | Description: Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment |
| L1005 | Tension based scoliosis orth | Description: Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment |
| L1006 | Scoliosis orth sag/ cor | Description: Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and interface, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1007 | Scoliosis orth s-c custom | Description: Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and interface, custom fabricated |
| L1010 | Ctlso axilla sling | Description: Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling |
| L1020 | Kyphosis pad | Description: Addition to ctlso or scoliosis orthosis, kyphosis pad |
| L1025 | Kyphosis pad floating | Description: Addition to ctlso or scoliosis orthosis, kyphosis pad, floating |
| L1030 | Lumbar bolster pad | Description: Addition to ctlso or scoliosis orthosis, lumbar bolster pad |
| L1040 | Lumbar or lumbar rib pad | Description: Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad |
| L1050 | Sternal pad | Description: Addition to ctlso or scoliosis orthosis, sternal pad |
| L1060 | Thoracic pad | Description: Addition to ctlso or scoliosis orthosis, thoracic pad |
| L1070 | Trapezius sling | Description: Addition to ctlso or scoliosis orthosis, trapezius sling |
| L1080 | Outrigger | Description: Addition to ctlso or scoliosis orthosis, outrigger |
| L1085 | Outrigger bil w/ vert extens | Description: Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions |
| L1090 | Lumbar sling | Description: Addition to ctlso or scoliosis orthosis, lumbar sling |
| L1100 | Ring flange plastic/leather | Description: Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather |
| L1110 | Ring flange plas/leather mol | Description: Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model |
| L1120 | Covers for upright each | Description: Addition to ctlso, scoliosis orthosis, cover for upright, each |
| L1200 | Furnsh initial orthosis only | Description: Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only |
| L1210 | Lateral thoracic extension | Description: Addition to tlso, (low profile), lateral thoracic extension |
| L1220 | Anterior thoracic extension | Description: Addition to tlso, (low profile), anterior thoracic extension |
| L1230 | Milwaukee type superstructur | Description: Addition to tlso, (low profile), milwaukee type superstructure |
| L1240 | Lumbar derotation pad | Description: Addition to tlso, (low profile), lumbar derotation pad |
| L1250 | Anterior asis pad | Description: Addition to tlso, (low profile), anterior asis pad |
| L1260 | Anterior thoracic derotation | Description: Addition to tlso, (low profile), anterior thoracic derotation pad |
| L1270 | Abdominal pad | Description: Addition to tlso, (low profile), abdominal pad |
| L1280 | Rib gusset (elastic) each | Description: Addition to tlso, (low profile), rib gusset (elastic), each |
| L1290 | Lateral trochanteric pad | Description: Addition to tlso, (low profile), lateral trochanteric pad |
| L1300 | Body jacket mold to patient | Description: Other scoliosis procedure, body jacket molded to patient model |
| L1310 | Post-operative body jacket | Description: Other scoliosis procedure, post-operative body jacket |
| L1320 | Pectus carinatum ortho cust | Description: Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated |
| L1499 | Spinal orthosis nos | Description: Spinal orthosis, not otherwise specified |
| L1600 | Ho flex frejka w/cov pre cst | Description: Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise |
| L1610 | Ho frejka cov only pre cst | Description: Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1620 | Ho flex pavlik harns pre cst | Description: Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1630 | Abduct control hip semi-flex | Description: Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated |
| L1640 | Pelv band/spread bar thigh c | Description: Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated |
| L1650 | Ho abduction hip adjustable | Description: Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment |
| L1652 | Ho bi thighcuffs w sprdr bar | Description: Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1653 | Ho abduction static ots | Description: Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf |
| L1660 | Ho abduction static plastic | Description: Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment |
| L1680 | Pelvic & hip control thigh c | Description: Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated |
| L1681 | Ho bilateral hip abduction | Description: Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1685 | Post-op hip abduct custom fa | Description: Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated |
| L1686 | Ho post-op hip abduction | Description: Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment |
| L1690 | Combination bilateral ho | Description: Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment |
| L1700 | Leg perthes orth toronto typ | Description: Legg perthes orthosis, (toronto type), custom fabricated |
| L1710 | Legg perthes orth newington | Description: Legg perthes orthosis, (newington type), custom fabricated |
| L1720 | Legg perthes orthosis trilat | Description: Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated |
| L1730 | Legg perthes orth scottish r | Description: Legg perthes orthosis, (scottish rite type), custom fabricated |
| L1755 | Legg perthes patten bottom t | Description: Legg perthes orthosis, (patten bottom type), custom fabricated |
| L1810 | Ko elastic with joints | Description: Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1812 | Ko elastic w/joints pre ots | Description: Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
| L1820 | Ko elas w/ condyle pads & jo | Description: Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1821 | Ko elas w/ condyle pads otf | Description: Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf |
| L1830 | Ko immob canvas long pre ots | Description: Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
| L1831 | Knee orth pos locking joint | Description: Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment |
| L1832 | Ko adj jnt pos r sup pre cst | Description: Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1833 | Ko adj jnt pos r sup pre ots | Description: Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
| L1834 | Ko w/0 joint rigid molded to | Description: Knee orthosis, without knee joint, rigid, custom fabricated |
| L1836 | Ko rigid w/o joints pre ots | Description: Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf |
| L1840 | Ko derot ant cruciate custom | Description: Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated |
| L1843 | Ko single upright pre cst | Description: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1844 | Ko w/adj jt rot cntrl molded | Description: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated |
| L1845 | Ko double upright pre cst | Description: Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1846 | Ko w adj flex/ext rotat mold | Description: Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated |
| L1847 | Ko dbl upright w/air pre cst | Description: Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1848 | Ko dbl upright w/air pre ots | Description: Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf |
| L1850 | Ko swedish type pre ots | Description: Knee orthosis, swedish type, prefabricated, off-the-shelf |
| L1851 | Ko single upright prefab ots | Description: Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
| L1852 | Ko double upright prefab ots | Description: Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
| L1860 | Ko supracondylar socket mold | Description: Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk) |
| L1900 | Afo sprng wir drsflx calf bd | Description: Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated |
| L1902 | Afo ankle gauntlet pre ots | Description: Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
| L1904 | Afo molded ankle gauntlet | Description: Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated |
| L1906 | Afo multilig ank sup pre ots | Description: Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
| L1907 | Afo supramalleolar custom | Description: Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
| L1910 | Afo sing bar clasp attach sh | Description: Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment |
| L1920 | Afo sing upright w/ adjust s | Description: Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated |
| L1930 | Afo plastic | Description: Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
| L1932 | Afo rig ant tib tcf/= custom | Description: Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1933 | Afo rig ant tib tcf/= ots | Description: Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf |
| L1940 | Afo molded to patient plasti | Description: Ankle foot orthosis, plastic or other material, custom fabricated |
| L1945 | Afo molded plas rig ant tib | Description: Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated |
| L1950 | Afo spiral molded to pt plas | Description: Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated |
| L1951 | Afo spiral prefab custom | Description: Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L1952 | Afo spiral prefab ots | Description: Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf |
| L1960 | Afo pos solid ank plastic mo | Description: Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
| L1970 | Afo plastic molded w/ankle j | Description: Ankle foot orthosis, plastic with ankle joint, custom fabricated |
| L1971 | Afo w/ankle joint, prefab | Description: Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
| L1980 | Afo sing solid stirrup calf | Description: Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated |
| L1990 | Afo doub solid stirrup calf | Description: Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated |
| L2000 | Kafo sing fre stirr thi/calf | Description: Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated |
| L2005 | Kafo sng/dbl mechanical act | Description: 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 | Kaf sng/dbl swg/stn mcpr cus | Description: 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 | Kafo sng solid stirrup w/o j | Description: 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 | Kafo dbl solid stirrup band/ | Description: Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated |
| L2030 | Kafo dbl solid stirrup w/o j | Description: 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 | Kafo pla sin up w/wo k/a cus | Description: 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 | Kafo plastic pediatric size | Description: Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment |
| L2036 | Kafo plas doub free knee mol | Description: Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated |
| L2037 | Kafo plas sing free knee mol | Description: Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated |
| L2038 | Kafo w/o joint multi-axis an | Description: Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated |
| L2040 | Hkafo torsion bil rot straps | Description: Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated |
| L2050 | Hkafo torsion cable hip pelv | Description: Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated |
| L2060 | Hkafo torsion ball bearing j | Description: Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated |
| L2070 | Hkafo torsion unilat rot str | Description: Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated |
| L2080 | Hkafo unilat torsion cable | Description: Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated |
| L2090 | Hkafo unilat torsion ball br | Description: Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated |
| L2106 | Afo tib fx cast plaster mold | Description: Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated |
| L2108 | Afo tib fx cast molded to pt | Description: Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated |
| L2112 | Afo tibial fracture soft | Description: Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment |
| L2114 | Afo tib fx semi-rigid | Description: Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment |
| L2116 | Afo tibial fracture rigid | Description: Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment |
| L2126 | Kafo fem fx cast thermoplas | Description: Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated |
| L2128 | Kafo fem fx cast molded to p | Description: Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated |
| L2132 | Kafo femoral fx cast soft | Description: Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment |
| L2134 | Kafo fem fx cast semi-rigid | Description: Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment |
| L2136 | Kafo femoral fx cast rigid | Description: Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment |
| L2180 | Plas shoe insert w ank joint | Description: Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints |
| L2182 | Drop lock knee | Description: Addition to lower extremity fracture orthosis, drop lock knee joint |
| L2184 | Limited motion knee joint | Description: Addition to lower extremity fracture orthosis, limited motion knee joint |
| L2186 | Adj motion knee jnt lerman t | Description: Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type |
| L2188 | Quadrilateral brim | Description: Addition to lower extremity fracture orthosis, quadrilateral brim |
| L2190 | Waist belt | Description: Addition to lower extremity fracture orthosis, waist belt |
| L2192 | Pelvic band & belt thigh fla | Description: Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt |
| L2200 | Limited ankle motion ea jnt | Description: Addition to lower extremity, limited ankle motion, each joint |
| L2210 | Dorsiflexion assist each joi | Description: Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
| L2220 | Dorsi & plantar flex ass/res | Description: Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
| L2230 | Split flat caliper stirr & p | Description: Addition to lower extremity, split flat caliper stirrups and plate attachment |
| L2232 | Rocker bottom, contact afo | Description: Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only |
| L2240 | Round caliper and plate atta | Description: Addition to lower extremity, round caliper and plate attachment |
| L2250 | Foot plate molded stirrup at | Description: Addition to lower extremity, foot plate, molded to patient model, stirrup attachment |
| L2260 | Reinforced solid stirrup | Description: Addition to lower extremity, reinforced solid stirrup (scott-craig type) |
| L2265 | Long tongue stirrup | Description: Addition to lower extremity, long tongue stirrup |
| L2270 | Varus/valgus strap padded/li | Description: Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
| L2275 | Plastic mod low ext pad/line | Description: Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
| L2280 | Molded inner boot | Description: Addition to lower extremity, molded inner boot |
| L2300 | Abduction bar jointed adjust | Description: Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable |
| L2310 | Abduction bar-straight | Description: Addition to lower extremity, abduction bar-straight |
| L2320 | Non-molded lacer | Description: Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only |
| L2330 | Lacer molded to patient mode | Description: Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
| L2335 | Anterior swing band | Description: Addition to lower extremity, anterior swing band |
| L2340 | Pre-tibial shell molded to p | Description: Addition to lower extremity, pre-tibial shell, molded to patient model |
| L2350 | Prosthetic type socket molde | Description: Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses) |
| L2360 | Extended steel shank | Description: Addition to lower extremity, extended steel shank |
| L2370 | Patten bottom | Description: Addition to lower extremity, patten bottom |
| L2375 | Torsion ank & half solid sti | Description: Addition to lower extremity, torsion control, ankle joint and half solid stirrup |
| L2380 | Torsion straight knee joint | Description: Addition to lower extremity, torsion control, straight knee joint, each joint |
| L2385 | Straight knee joint heavy du | Description: Addition to lower extremity, straight knee joint, heavy duty, each joint |
| L2387 | Add le poly knee custom kafo | Description: Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint |
| L2390 | Offset knee joint each | Description: Addition to lower extremity, offset knee joint, each joint |
| L2395 | Offset knee joint heavy duty | Description: Addition to lower extremity, offset knee joint, heavy duty, each joint |
| L2397 | Suspension sleeve lower ext | Description: Addition to lower extremity orthosis, suspension sleeve |
| L2405 | Knee joint drop lock ea jnt | Description: Addition to knee joint, drop lock, each |
| L2415 | Knee joint cam lock each joi | Description: Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint |
| L2425 | Knee disc/dial lock/adj flex | Description: Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint |
| L2430 | Knee jnt ratchet lock ea jnt | Description: Addition to knee joint, ratchet lock for active and progressive knee extension, each joint |
| L2492 | Knee lift loop drop lock rin | Description: Addition to knee joint, lift loop for drop lock ring |
| L2500 | Thi/glut/ischia wgt bearing | Description: Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring |
| L2510 | Th/wght bear quad-lat brim m | Description: Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model |
| L2520 | Th/wght bear quad-lat brim c | Description: Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted |
| L2525 | Th/wght bear nar m-l brim mo | Description: Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model |
| L2526 | Th/wght bear nar m-l brim cu | Description: Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted |
| L2530 | Thigh/wght bear lacer non-mo | Description: Addition to lower extremity, thigh-weight bearing, lacer, non-molded |
| L2540 | Thigh/wght bear lacer molded | Description: Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model |
| L2550 | Thigh/wght bear high roll cu | Description: Addition to lower extremity, thigh/weight bearing, high roll cuff |
| L2570 | Hip clevis type 2 posit jnt | Description: Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each |
| L2580 | Pelvic control pelvic sling | Description: Addition to lower extremity, pelvic control, pelvic sling |
| L2600 | Hip clevis/thrust bearing fr | Description: Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each |
| L2610 | Hip clevis/thrust bearing lo | Description: Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each |
| L2620 | Pelvic control hip heavy dut | Description: Addition to lower extremity, pelvic control, hip joint, heavy duty, each |
| L2622 | Hip joint adjustable flexion | Description: Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each |
| L2624 | Hip adj flex ext abduct cont | Description: Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each |
| L2627 | Plastic mold recipro hip & c | Description: Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables |
| L2628 | Metal frame recipro hip & ca | Description: Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables |
| L2630 | Pelvic control band & belt u | Description: Addition to lower extremity, pelvic control, band and belt, unilateral |
| L2640 | Pelvic control band & belt b | Description: Addition to lower extremity, pelvic control, band and belt, bilateral |
| L2650 | Pelv & thor control gluteal | Description: Addition to lower extremity, pelvic and thoracic control, gluteal pad, each |
| L2660 | Thoracic control thoracic ba | Description: Addition to lower extremity, thoracic control, thoracic band |
| L2670 | Thorac cont paraspinal uprig | Description: Addition to lower extremity, thoracic control, paraspinal uprights |
| L2680 | Thorac cont lat support upri | Description: Addition to lower extremity, thoracic control, lateral support uprights |
| L2750 | Plating chrome/nickel pr bar | Description: Addition to lower extremity orthosis, plating chrome or nickel, per bar |
| L2755 | Carbon graphite lamination | Description: Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only |
| L2760 | Extension per extension per | Description: Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth) |
| L2768 | Ortho sidebar disconnect | Description: Orthotic side bar disconnect device, per bar |
| L2780 | Non-corrosive finish | Description: Addition to lower extremity orthosis, non-corrosive finish, per bar |
| L2785 | Drop lock retainer each | Description: Addition to lower extremity orthosis, drop lock retainer, each |
| L2795 | Knee control full kneecap | Description: Addition to lower extremity orthosis, knee control, full kneecap |
| L2800 | Knee cap medial or lateral p | Description: Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only |
| L2810 | Knee control condylar pad | Description: Addition to lower extremity orthosis, knee control, condylar pad |
| L2820 | Soft interface below knee se | Description: Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
| L2830 | Soft interface above knee se | Description: Addition to lower extremity orthosis, soft interface for molded plastic, above knee section |
| L2840 | Tibial length sock fx or equ | Description: Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
| L2850 | Femoral lgth sock fx or equa | Description: Addition to lower extremity orthosis, femoral length sock, fracture or equal, each |
| L2861 | Torsion mechanism knee/ankle | Description: Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L2999 | Lower extremity orthosis nos | Description: Lower extremity orthoses, not otherwise specified |
| L3000 | Ft insert ucb berkeley shell | Description: Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
| L3001 | Foot insert remov molded spe | Description: Foot, insert, removable, molded to patient model, spenco, each |
| L3002 | Foot insert plastazote or eq | Description: Foot, insert, removable, molded to patient model, plastazote or equal, each |
| L3003 | Foot insert silicone gel eac | Description: Foot, insert, removable, molded to patient model, silicone gel, each |
| L3010 | Foot longitudinal arch suppo | Description: Foot, insert, removable, molded to patient model, longitudinal arch support, each |
| L3020 | Foot longitud/metatarsal sup | Description: Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
| L3030 | Foot arch support remov prem | Description: Foot, insert, removable, formed to patient foot, each |
| L3031 | Foot lamin/prepreg composite | Description: Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each |
| L3040 | Ft arch suprt premold longit | Description: Foot, arch support, removable, premolded, longitudinal, each |
| L3050 | Foot arch supp premold metat | Description: Foot, arch support, removable, premolded, metatarsal, each |
| L3060 | Foot arch supp longitud/meta | Description: Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
| L3070 | Arch suprt att to sho longit | Description: Foot, arch support, non-removable attached to shoe, longitudinal, each |
| L3080 | Arch supp att to shoe metata | Description: Foot, arch support, non-removable attached to shoe, metatarsal, each |
| L3090 | Arch supp att to shoe long/m | Description: Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each |
| L3100 | Hallus-valgus nt dyn pre ots | Description: Hallus-valgus night dynamic splint, prefabricated, off-the-shelf |
| L3140 | Abduction rotation bar shoe | Description: Foot, abduction rotation bar, including shoes |
| L3150 | Abduct rotation bar w/o shoe | Description: Foot, abduction rotation bar, without shoes |
| L3160 | Shoe styled positioning dev | Description: Foot, adjustable shoe-styled positioning device |
| L3161 | Foot, adductus position, adj | Description: Foot, adductus positioning device, adjustable |
| L3170 | Foot plas heel stabi pre ots | Description: Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each |
| L3201 | Oxford w supinat/pronat inf | Description: Orthopedic shoe, oxford with supinator or pronator, infant |
| L3202 | Oxford w/ supinat/pronator c | Description: Orthopedic shoe, oxford with supinator or pronator, child |
| L3203 | Oxford w/ supinator/pronator | Description: Orthopedic shoe, oxford with supinator or pronator, junior |
| L3204 | Hightop w/ supp/pronator inf | Description: Orthopedic shoe, hightop with supinator or pronator, infant |
| L3206 | Hightop w/ supp/pronator chi | Description: Orthopedic shoe, hightop with supinator or pronator, child |
| L3207 | Hightop w/ supp/pronator jun | Description: Orthopedic shoe, hightop with supinator or pronator, junior |
| L3208 | Surgical boot each infant | Description: Surgical boot, each, infant |
| L3209 | Surgical boot each child | Description: Surgical boot, each, child |
| L3211 | Surgical boot each junior | Description: Surgical boot, each, junior |
| L3212 | Benesch boot pair infant | Description: Benesch boot, pair, infant |
| L3213 | Benesch boot pair child | Description: Benesch boot, pair, child |
| L3214 | Benesch boot pair junior | Description: Benesch boot, pair, junior |
| L3215 | Orthopedic ftwear ladies oxf | Description: Orthopedic footwear, ladies shoe, oxford, each |
| L3216 | Orthoped ladies shoes dpth i | Description: Orthopedic footwear, ladies shoe, depth inlay, each |
| L3217 | Ladies shoes hightop depth i | Description: Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
| L3219 | Orthopedic mens shoes oxford | Description: Orthopedic footwear, mens shoe, oxford, each |
| L3221 | Orthopedic mens shoes dpth i | Description: Orthopedic footwear, mens shoe, depth inlay, each |
| L3222 | Mens shoes hightop depth inl | Description: Orthopedic footwear, mens shoe, hightop, depth inlay, each |
| L3224 | Woman's shoe oxford brace | Description: Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis) |
| L3225 | Man's shoe oxford brace | Description: Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis) |
| L3230 | Custom shoes depth inlay | Description: Orthopedic footwear, custom shoe, depth inlay, each |
| L3250 | Custom mold shoe remov prost | Description: Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each |
| L3251 | Shoe molded to pt silicone s | Description: Foot, shoe molded to patient model, silicone shoe, each |
| L3252 | Shoe molded plastazote cust | Description: Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each |
| L3253 | Shoe molded plastazote cust | Description: Foot, molded shoe plastazote (or similar) custom fitted, each |
| L3254 | Orth foot non-stndard size/w | Description: Non-standard size or width |
| L3255 | Orth foot non-standard size/ | Description: Non-standard size or length |
| L3257 | Orth foot add charge split s | Description: Orthopedic footwear, additional charge for split size |
| L3260 | Ambulatory surgical boot eac | Description: Surgical boot/shoe, each |
| L3265 | Plastazote sandal each | Description: Plastazote sandal, each |
| L3300 | Sho lift taper to metatarsal | Description: Lift, elevation, heel, tapered to metatarsals, per inch |
| L3310 | Shoe lift elev heel/sole neo | Description: Lift, elevation, heel and sole, neoprene, per inch |
| L3320 | Shoe lift elev heel/sole cor | Description: Lift, elevation, heel and sole, cork, per inch |
| L3330 | Lifts elevation metal extens | Description: Lift, elevation, metal extension (skate) |
| L3332 | Shoe lifts tapered to one-ha | Description: Lift, elevation, inside shoe, tapered, up to one-half inch |
| L3334 | Shoe lifts elevation heel /i | Description: Lift, elevation, heel, per inch |
| L3340 | Shoe wedge sach | Description: Heel wedge, sach |
| L3350 | Shoe heel wedge | Description: Heel wedge |
| L3360 | Shoe sole wedge outside sole | Description: Sole wedge, outside sole |
| L3370 | Shoe sole wedge between sole | Description: Sole wedge, between sole |
| L3380 | Shoe clubfoot wedge | Description: Clubfoot wedge |
| L3390 | Shoe outflare wedge | Description: Outflare wedge |
| L3400 | Shoe metatarsal bar wedge ro | Description: Metatarsal bar wedge, rocker |
| L3410 | Shoe metatarsal bar between | Description: Metatarsal bar wedge, between sole |
| L3420 | Full sole/heel wedge btween | Description: Full sole and heel wedge, between sole |
| L3430 | Sho heel count plast reinfor | Description: Heel, counter, plastic reinforced |
| L3440 | Heel leather reinforced | Description: Heel, counter, leather reinforced |
| L3450 | Shoe heel sach cushion type | Description: Heel, sach cushion type |
| L3455 | Shoe heel new leather standa | Description: Heel, new leather, standard |
| L3460 | Shoe heel new rubber standar | Description: Heel, new rubber, standard |
| L3465 | Shoe heel thomas with wedge | Description: Heel, thomas with wedge |
| L3470 | Shoe heel thomas extend to b | Description: Heel, thomas extended to ball |
| L3480 | Shoe heel pad & depress for | Description: Heel, pad and depression for spur |
| L3485 | Shoe heel pad removable for | Description: Heel, pad, removable for spur |
| L3500 | Ortho shoe add leather insol | Description: Orthopedic shoe addition, insole, leather |
| L3510 | Orthopedic shoe add rub insl | Description: Orthopedic shoe addition, insole, rubber |
| L3520 | O shoe add felt w leath insl | Description: Orthopedic shoe addition, insole, felt covered with leather |
| L3530 | Ortho shoe add half sole | Description: Orthopedic shoe addition, sole, half |
| L3540 | Ortho shoe add full sole | Description: Orthopedic shoe addition, sole, full |
| L3550 | O shoe add standard toe tap | Description: Orthopedic shoe addition, toe tap standard |
| L3560 | O shoe add horseshoe toe tap | Description: Orthopedic shoe addition, toe tap, horseshoe |
| L3570 | O shoe add instep extension | Description: Orthopedic shoe addition, special extension to instep (leather with eyelets) |
| L3580 | O shoe add instep velcro clo | Description: Orthopedic shoe addition, convert instep to velcro closure |
| L3590 | O shoe convert to sof counte | Description: Orthopedic shoe addition, convert firm shoe counter to soft counter |
| L3595 | Ortho shoe add march bar | Description: Orthopedic shoe addition, march bar |
| L3600 | Trans shoe calip plate exist | Description: Transfer of an orthosis from one shoe to another, caliper plate, existing |
| L3610 | Trans shoe caliper plate new | Description: Transfer of an orthosis from one shoe to another, caliper plate, new |
| L3620 | Trans shoe solid stirrup exi | Description: Transfer of an orthosis from one shoe to another, solid stirrup, existing |
| L3630 | Trans shoe solid stirrup new | Description: Transfer of an orthosis from one shoe to another, solid stirrup, new |
| L3640 | Shoe dennis browne splint bo | Description: Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes |
| L3649 | Orthopedic shoe modifica nos | Description: Orthopedic shoe, modification, addition or transfer, not otherwise specified |
| L3650 | So 8 abd restraint pre ots | Description: Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
| L3660 | So 8 ab rstr can/web pre ots | Description: Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
| L3670 | So acro/clav can web pre ots | Description: Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
| L3671 | So cap design w/o jnts cf | Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3674 | So airplane w/wo joint cf | Description: 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 | So vest canvas/web pre ots | Description: Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf |
| L3677 | So hard plas stabili pre cst | Description: 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 | So hard plas stabili pre ots | Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| L3702 | Eo w/o joints cf | Description: Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3710 | Eo elas w/metal jnts pre ots | Description: Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf |
| L3720 | Forearm/arm cuffs free motio | Description: Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated |
| L3730 | Forearm/arm cuffs ext/flex a | Description: Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated |
| L3740 | Cuffs adj lock w/ active con | Description: Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated |
| L3760 | Eo adj jt prefab custom fit | Description: 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 |
| L3761 | Eo, adj lock joint prefab ot | Description: Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf |
| L3762 | Eo rigid w/o joints pre ots | Description: Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf |
| L3763 | Ewho rigid w/o jnts cf | Description: Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3764 | Ewho w/joint(s) cf | Description: 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 | Ewhfo rigid w/o jnts cf | Description: Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3766 | Ewhfo w/joint(s) cf | Description: 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 |
| L3806 | Whfo w/joint(s) custom fab | Description: 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 |
| L3807 | Whfo w/o joints pre cst | Description: Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3808 | Whfo, rigid w/o joints | Description: Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
| L3809 | Whfo w/o joints pre ots | Description: Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
| L3891 | Torsion mechanism wrist/elbo | Description: Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L3900 | Hinge extension/flex wrist/f | Description: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated |
| L3901 | Hinge ext/flex wrist finger | Description: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated |
| L3904 | Whfo electric custom fitted | Description: Wrist hand finger orthosis, external powered, electric, custom fabricated |
| L3905 | Who w/nontorsion jnt(s) cf | Description: Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3906 | Who w/o joints cf | Description: Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3908 | Who cock-up nonmolde pre ots | Description: Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
| L3912 | Hfo flexion glove pre ots | Description: Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf |
| L3913 | Hfo w/o joints cf | Description: Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3915 | Who nontorsion jnts pre cst | Description: 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 | Who nontorsion jnts pre ots | Description: Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
| L3917 | Metacarp fx orthosis pre cst | Description: 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 |
| L3918 | Metacarp fx orthosis pre ots | Description: Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf |
| L3919 | Ho w/o joints cf | Description: Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3921 | Hfo w/joint(s) cf | Description: Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3923 | Hfo without joints pre cst | Description: 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 | Hfo without joints pre ots | Description: Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| L3925 | Fo pip dip jnt/sprng pre ots | Description: Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf |
| L3927 | Fo pip dip no jt spr pre ots | Description: 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 |
| L3929 | Hfo nontorsion jnts pre cst | Description: 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 | Hfo nontorsion jnts pre ots | Description: 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 | Whfo nontorsion joint prefab | Description: 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 |
| L3933 | Fo w/o joints cf | Description: Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3935 | Fo nontorsion joint cf | Description: Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3956 | Add joint upper ext orthosis | Description: Addition of joint to upper extremity orthosis, any material; per joint |
| L3960 | Sewho airplan desig abdu pos | Description: Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
| L3961 | Sewho cap design w/o jnts cf | Description: Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3962 | Sewho erbs palsey design abd | Description: Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment |
| L3967 | Sewho airplane w/o jnts cf | Description: 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 |
| L3971 | Sewho cap design w/jnt(s) cf | Description: 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 |
| L3973 | Sewho airplane w/jnt(s) cf | Description: 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 |
| L3975 | Sewhfo cap design w/o jnt cf | Description: Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3976 | Sewhfo airplane w/o jnts cf | Description: 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 | Sewhfo cap desgn w/jnt(s) cf | Description: 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 | Sewhfo airplane w/jnt(s) cf | Description: 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 | Up ext fx orthos humeral nos | Description: Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment |
| L3981 | Ue fx orth shoul cap forearm | Description: 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 ext fx orthosis rad/ul | Description: Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment |
| L3984 | Upper ext fx orthosis wrist | Description: Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
| L3995 | Sock fracture or equal each | Description: Addition to upper extremity orthosis, sock, fracture or equal, each |
| L3999 | Upper limb orthosis nos | Description: Upper limb orthosis, not otherwise specified |
| L4000 | Repl girdle milwaukee orth | Description: Replace girdle for spinal orthosis (ctlso or so) |
| L4002 | Replace strap, any orthosis | Description: Replacement strap, any orthosis, includes all components, any length, any type |
| L4010 | Replace trilateral socket br | Description: Replace trilateral socket brim |
| L4020 | Replace quadlat socket brim | Description: Replace quadrilateral socket brim, molded to patient model |
| L4030 | Replace socket brim cust fit | Description: Replace quadrilateral socket brim, custom fitted |
| L4040 | Replace molded thigh lacer | Description: Replace molded thigh lacer, for custom fabricated orthosis only |
| L4045 | Replace non-molded thigh lac | Description: Replace non-molded thigh lacer, for custom fabricated orthosis only |
| L4050 | Replace molded calf lacer | Description: Replace molded calf lacer, for custom fabricated orthosis only |
| L4055 | Replace non-molded calf lace | Description: Replace non-molded calf lacer, for custom fabricated orthosis only |
| L4060 | Replace high roll cuff | Description: Replace high roll cuff |
| L4070 | Replace prox & dist upright | Description: Replace proximal and distal upright for kafo |
| L4080 | Repl met band kafo-afo prox | Description: Replace metal bands kafo, proximal thigh |
| L4090 | Repl met band kafo-afo calf/ | Description: Replace metal bands kafo-afo, calf or distal thigh |
| L4100 | Repl leath cuff kafo prox th | Description: Replace leather cuff kafo, proximal thigh |
| L4110 | Repl leath cuff kafo-afo cal | Description: Replace leather cuff kafo-afo, calf or distal thigh |
| L4130 | Replace pretibial shell | Description: Replace pretibial shell |
| L4205 | Ortho dvc repair per 15 min | Description: Repair of orthotic device, labor component, per 15 minutes |
| L4210 | Orth dev repair/repl minor p | Description: Repair of orthotic device, repair or replace minor parts |
| L4350 | Ankle control ortho pre ots | Description: Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
| L4360 | Pneumat walking boot pre cst | Description: 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 | Pneuma/vac walk boot pre ots | Description: Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4370 | Pneum full leg splnt pre ots | Description: Pneumatic full leg splint, prefabricated, off-the-shelf |
| L4386 | Non-pneum walk boot pre cst | Description: 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 | Non-pneum walk boot pre ots | Description: Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4392 | Replace afo soft interface | Description: Replacement, soft interface material, static afo |
| L4394 | Replace foot drop spint | Description: Replace soft interface material, foot drop splint |
| L4396 | Static or dynami afo pre cst | Description: 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 dynami afo pre ots | Description: 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 pre ots | Description: Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf |
| L4631 | Afo, walk boot type, cus fab | Description: Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated |
| L5000 | Sho insert w arch toe filler | Description: Partial foot, shoe insert with longitudinal arch, toe filler |
| L5010 | Mold socket ank hgt w/ toe f | Description: Partial foot, molded socket, ankle height, with toe filler |
| L5020 | Tibial tubercle hgt w/ toe f | Description: Partial foot, molded socket, tibial tubercle height, with toe filler |
| L5050 | Ank symes mold sckt sach ft | Description: Ankle, symes, molded socket, sach foot |
| L5060 | Symes met fr leath socket ar | Description: Ankle, symes, metal frame, molded leather socket, articulated ankle/foot |
| L5100 | Molded socket shin sach foot | Description: Below knee, molded socket, shin, sach foot |
| L5105 | Plast socket jts/thgh lacer | Description: Below knee, plastic socket, joints and thigh lacer, sach foot |
| L5150 | Mold sckt ext knee shin sach | Description: Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot |
| L5160 | Mold socket bent knee shin s | Description: Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot |
| L5200 | Kne sing axis fric shin sach | Description: Above knee, molded socket, single axis constant friction knee, shin, sach foot |
| L5210 | No knee/ankle joints w/ ft b | Description: Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each |
| L5220 | No knee joint with artic ali | Description: Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each |
| L5230 | Fem focal defic constant fri | Description: Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot |
| L5250 | Hip canad sing axi cons fric | Description: Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot |
| L5270 | Tilt table locking hip sing | Description: Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot |
| L5280 | Hemipelvect canad sing axis | Description: Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot |
| L5301 | Bk mold socket sach ft endo | Description: Below knee, molded socket, shin, sach foot, endoskeletal system |
| L5312 | Knee disart, sach ft, endo | Description: Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system |
| L5321 | Ak open end sach | Description: Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee |
| L5331 | Hip disart canadian sach ft | Description: Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot |
| L5341 | Hemipelvectomy canadian sach | Description: Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot |
| L5400 | Postop dress & 1 cast chg bk | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee |
| L5410 | Postop dsg bk ea add cast ch | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment |
| L5420 | Postop dsg & 1 cast chg ak/d | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation |
| L5430 | Postop dsg ak ea add cast ch | Description: Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment |
| L5450 | Postop app non-wgt bear dsg | Description: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee |
| L5460 | Postop app non-wgt bear dsg | Description: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee |
| L5500 | Init bk ptb plaster direct | Description: Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed |
| L5505 | Init ak ischal plstr direct | Description: Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed |
| L5510 | Prep bk ptb plaster molded | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model |
| L5520 | Perp bk ptb thermopls direct | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed |
| L5530 | Prep bk ptb thermopls molded | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model |
| L5535 | Prep bk ptb open end socket | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket |
| L5540 | Prep bk ptb laminated socket | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model |
| L5560 | Prep ak ischial plast molded | Description: Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model |
| L5570 | Prep ak ischial direct form | Description: Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed |
| L5580 | Prep ak ischial thermo mold | Description: Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model |
| L5585 | Prep ak ischial open end | Description: Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket |
| L5590 | Prep ak ischial laminated | Description: Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model |
| L5595 | Hip disartic sach thermopls | Description: Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model |
| L5600 | Hip disart sach laminat mold | Description: Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model |
| L5610 | Above knee hydracadence | Description: Addition to lower extremity, endoskeletal system, above knee, hydracadence system |
| L5611 | Ak 4 bar link w/fric swing | Description: Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control |
| L5613 | Ak 4 bar ling w/hydraul swig | Description: Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control |
| L5614 | 4-bar link above knee w/swng | Description: Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control |
| L5615 | Ak 4 bar link hydl swg/stanc | Description: Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control |
| L5616 | Ak univ multiplex sys frict | Description: Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control |
| L5617 | Ak/bk self-aligning unit ea | Description: Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each |
| L5618 | Test socket symes | Description: Addition to lower extremity, test socket, symes |
| L5620 | Test socket below knee | Description: Addition to lower extremity, test socket, below knee |
| L5622 | Test socket knee disarticula | Description: Addition to lower extremity, test socket, knee disarticulation |
| L5624 | Test socket above knee | Description: Addition to lower extremity, test socket, above knee |
| L5626 | Test socket hip disarticulat | Description: Addition to lower extremity, test socket, hip disarticulation |
| L5628 | Test socket hemipelvectomy | Description: Addition to lower extremity, test socket, hemipelvectomy |
| L5629 | Below knee acrylic socket | Description: Addition to lower extremity, below knee, acrylic socket |
| L5630 | Syme typ expandabl wall sckt | Description: Addition to lower extremity, symes type, expandable wall socket |
| L5631 | Ak/knee disartic acrylic soc | Description: Addition to lower extremity, above knee or knee disarticulation, acrylic socket |
| L5632 | Symes type ptb brim design s | Description: Addition to lower extremity, symes type, 'ptb' brim design socket |
| L5634 | Symes type poster opening so | Description: Addition to lower extremity, symes type, posterior opening (canadian) socket |
| L5636 | Symes type medial opening so | Description: Addition to lower extremity, symes type, medial opening socket |
| L5637 | Below knee total contact | Description: Addition to lower extremity, below knee, total contact |
| L5638 | Below knee leather socket | Description: Addition to lower extremity, below knee, leather socket |
| L5639 | Below knee wood socket | Description: Addition to lower extremity, below knee, wood socket |
| L5640 | Knee disarticulat leather so | Description: Addition to lower extremity, knee disarticulation, leather socket |
| L5642 | Above knee leather socket | Description: Addition to lower extremity, above knee, leather socket |
| L5643 | Hip flex inner socket ext fr | Description: Addition to lower extremity, hip disarticulation, flexible inner socket, external frame |