2024 HCPCS Code L0484
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
TAGS: custom motion anterior symphysis overlapping plaster sternal straps inferior interface piece sacrococcygeal enhanced junction lateral transverse terminates triplanar carved multiple gross pubis extends restricts plastic rigid scapular strength posterior fabricated shell trunk
| Short Description | Tlso rigid plastic cust fab |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Action Effective Date | January 01, 2003 |
| HCPCS Code Added Date | January 01, 2003 |
| HCPCS Pricing Indicator Code | 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Issues Manual Reference Section Number | |
| HCPCS Type Of Service Code | P - Lump sum purchase of DME, prosthetics, orthotics |
| HCPCS Anesthesia Base Unit Quantity | 0 |
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