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HCPCS Procedure & Supply Codes
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Orthotic Devices & Services
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Orthotic Devices -- Scoliosis
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Thoracic-Lumbar-Sacral Orthosis (TLSO) (Low Profile)
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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 |
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