Showing codes KT (Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item) — L0462 (Tlso, triplanar 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 sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment)

KT - Item from noncontract supply
Long description: Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
Code added date: 20070701.
Code effective date: 20080401.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

KU - Dmepos comp bid prgm no 3
Long description: Dmepos item subject to dmepos competitive bidding program number 3
Code added date: 20070701.
Code effective date: 20070701.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

KV - Dmepos item, profession serv
Long description: Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
Code added date: 20080101.
Code effective date: 20080101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

KW - Dmepos comp bid prgm no 4
Long description: Dmepos item subject to dmepos competitive bidding program number 4
Code added date: 20080101.
Code effective date: 20080101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

KX - Documentation on file
Long description: Requirements specified in the medical policy have been met
Code added date: 20020701.
Code effective date: 20020701.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

KY - Dmepos comp bid prgm no 5
Long description: Dmepos item subject to dmepos competitive bidding program number 5
Code added date: 20080101.
Code effective date: 20080101.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

KZ - New cov not implement by m+c
Long description: New coverage not implemented by managed care
Code added date: 20031001.
Code effective date: 20031001.
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0112 - Cranial cervical orthosis
Long description: Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated
Code added date: 20040101.
Code effective date: 20040101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0113 - Cranial cervical torticollis
Long description: Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment
Code added date: 20090101.
Code effective date: 20090101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0120 - Cerv flex n/adj foam pre ots
Long description: Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)
Code added date: 19820101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0130 - Flex thermoplastic collar mo
Long description: Cervical, flexible, thermoplastic collar, molded to patient
Code added date: 19840101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0140 - Cervical semi-rigid adjustab
Long description: Cervical, semi-rigid, adjustable (plastic collar)
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0150 - Cerv semi-rig adj molded chn
Long description: Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0160 - Cerv sr wire occ/man pre ots
Long description: Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf
Code added date: 19820101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0170 - Cervical collar molded to pt
Long description: Cervical, collar, molded to patient model
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0172 - Cerv col sr foam 2pc pre ots
Long description: Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf
Code added date: 19880101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0174 - Cerv sr 2pc thor ext pre ots
Long description: Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf
Code added date: 19880101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0180 - Cer post col occ/man sup adj
Long description: Cervical, multiple post collar, occipital/mandibular supports, adjustable
Code added date: 19840101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0190 - Cerv collar supp adj cerv ba
Long description: Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0200 - Cerv col supp adj bar & thor
Long description: Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension
Code added date: 19840101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0220 - Thor rib belt custom fabrica
Long description: Thoracic, rib belt, custom fabricated
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0430 - Dewall posture protector
Long description: Spinal orthosis, anterior-posterior-lateral control, with interface material, custom fitted (dewall posture protector only)
Code added date: 19880101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0450 - Tlso flex trunk/thor pre ots
Long description: Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
Code added date: 20030101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0452 - Tlso flex custom fab thoraci
Long description: Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated
Code added date: 20030101.
Code effective date: 20030101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0454 - Tlso trnk sj-t9 pre cst
Long description: Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Code added date: 20030101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0455 - Tlso flex trnk sj-t9 pre ots
Long description: Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
Code added date: 20140101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0456 - Tlso flex trnk sj-ss pre cst
Long description: Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Code added date: 20030101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0457 - Tlso flex trnk sj-ss pre ots
Long description: Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf
Code added date: 20140101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0458 - Tlso 2mod symphis-xipho pre
Long description: Tlso, triplanar 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, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
Code added date: 20030101.
Code effective date: 20030101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0460 - Tlso 2 shl symphys-stern cst
Long description: Tlso, triplanar 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 sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
Code added date: 20030101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L0462 - Tlso 3mod sacro-scap pre
Long description: Tlso, triplanar 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 sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
Code added date: 20030101.
Code effective date: 20030101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF