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Find the standardized codes for lumbar orthosis (back brace) devices that provide lumbar support and reduce load on the intervertebral discs. Learn the details of each code and how to use them for Medicare and other health insurance claims.
Find the HCPCS L-Codes for braces, trusses, and artificial limbs, including back braces, cervical collars, and thoracic supports. The L-Codes cover the types, features, and customizations of the devices, as well as the services and adjustments related to them.
A custom-fabricated back brace (individually constructed to fit a specific member from component materials) is considered medically necessary if there is a failure, contraindication, or intolerance to a custom-fitted back brace;
Find the HCPCS codes for lumbar-sacral orthotics (LSO), a type of back brace that provides lumbo-sacral support and reduces load on the intervertebral discs. The codes range from L0628 to L0640 and vary by design, fabrication, and fit.
Oscar members with conditions affecting the back or spine may be eligible for coverage of special types of back braces known as spinal orthoses. Spinal orthoses function by providing a rigid structure to stabilize, align, and/or support the spine. These devices can be used for a number of conditions, including pain, deformities, and for
Suppliers must affix the HCPCS modifier "KT" to claims for OTS back or knee braces furnished to beneficiaries who permanently reside in a CBA and need a competitively bid item when they travel outside of the CBA where they reside.
This guideline provides evidence-based criteria for utilization management decisions of spinal orthoses (back braces) for Oscar members. It covers definitions, indications, and levels of customization of different types of braces, but does not include CPT codes.
OTS knee brace HCPCS codes: L1812, L1830, L1833, L1836, L1850, L1851, and L1852; Custom Fabricated. View Custom Items for information on medical necessity and billing not otherwise classified (NOC) codes. Custom Fit Orthotics Without Corresponding Off-the-Shelf Code
This document provides CPT® coding examples for various spine procedures, including anterior and posterior cervical and lumbar fusions, arthroplasty, laminoplasty, and more. The codes for interbody fusion and instrumentation are 22853 and 22856, which can be billed together with modifier 59.
Learn how to use HCPCS code L0650 for lumbosacral orthotics, a brace for the lower back, with modifiers 96, 97, and AV. See real-life scenarios and examples of different types of lumbosacral orthotics and their applications.
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