Showing codes L3971 (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) — L4350 (Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf)

L3971 - Sewho cap design w/jnt(s) cf
Long 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
Code added date: 20060101.
Code effective date: 20060101.
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).
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L3973 - Sewho airplane w/jnt(s) cf
Long 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
Code added date: 20060101.
Code effective date: 20060101.
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).
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L3975 - Sewhfo cap design w/o jnt cf
Long description: Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
Code added date: 20060101.
Code effective date: 20060101.
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).
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L3976 - Sewhfo airplane w/o jnts cf
Long 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
Code added date: 20060101.
Code effective date: 20060101.
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).
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L3977 - Sewhfo cap desgn w/jnt(s) cf
Long 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
Code added date: 20060101.
Code effective date: 20060101.
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).
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L3978 - Sewhfo airplane w/jnt(s) cf
Long 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
Code added date: 20060101.
Code effective date: 20060101.
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).
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L3980 - Up ext fx orthos humeral nos
Long description: Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment
Code added date: 19820101.
Code effective date: 20150101.
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).
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L3981 - Ue fx orth shoul cap forearm
Long 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
Code added date: 20150101.
Code effective date: 20150101.
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).
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L3982 - Upper ext fx orthosis rad/ul
Long description: Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
Code added date: 19840101.
Code effective date: 20010101.
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).
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L3984 - Upper ext fx orthosis wrist
Long description: Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment
Code added date: 19820101.
Code effective date: 20010101.
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).
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L3995 - Sock fracture or equal each
Long description: Addition to upper extremity orthosis, sock, fracture or equal, each
Code added date: 19890101.
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).
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L3999 - Upper limb orthosis nos
Long description: Upper limb orthosis, not otherwise specified
Code added date: 19820101.
Code effective date: 19980101.
Pricing Indicator Code(s): 46 ; (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).
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L4000 - Repl girdle milwaukee orth
Long description: Replace girdle for spinal orthosis (ctlso or so)
Code added date: 19850101.
Code effective date: 20020101.
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).
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L4002 - Replace strap, any orthosis
Long description: Replacement strap, any orthosis, includes all components, any length, any type
Code added date: 20050101.
Code effective date: 20050101.
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).
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L4010 - Replace trilateral socket br
Long description: Replace trilateral socket brim
Code added date: 19850101.
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).
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L4020 - Replace quadlat socket brim
Long description: Replace quadrilateral socket brim, molded to patient model
Code added date: 19850101.
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).
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L4030 - Replace socket brim cust fit
Long description: Replace quadrilateral socket brim, custom fitted
Code added date: 19850101.
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).
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L4040 - Replace molded thigh lacer
Long description: Replace molded thigh lacer, for custom fabricated orthosis only
Code added date: 19850101.
Code effective date: 20050101.
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).
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L4045 - Replace non-molded thigh lac
Long description: Replace non-molded thigh lacer, for custom fabricated orthosis only
Code added date: 19880101.
Code effective date: 20050101.
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).
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L4050 - Replace molded calf lacer
Long description: Replace molded calf lacer, for custom fabricated orthosis only
Code added date: 19850101.
Code effective date: 20050101.
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).
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L4055 - Replace non-molded calf lace
Long description: Replace non-molded calf lacer, for custom fabricated orthosis only
Code added date: 19880101.
Code effective date: 20050101.
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).
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L4060 - Replace high roll cuff
Long description: Replace high roll cuff
Code added date: 19850101.
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).
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L4070 - Replace prox & dist upright
Long description: Replace proximal and distal upright for kafo
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).
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L4080 - Repl met band kafo-afo prox
Long description: Replace metal bands kafo, proximal thigh
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).
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L4090 - Repl met band kafo-afo calf/
Long description: Replace metal bands kafo-afo, calf or distal thigh
Code added date: 19850101.
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).
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L4100 - Repl leath cuff kafo prox th
Long description: Replace leather cuff kafo, proximal thigh
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).
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L4110 - Repl leath cuff kafo-afo cal
Long description: Replace leather cuff kafo-afo, calf or distal thigh
Code added date: 19850101.
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).
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L4130 - Replace pretibial shell
Long description: Replace pretibial shell
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).
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L4205 - Ortho dvc repair per 15 min
Long description: Repair of orthotic device, labor component, per 15 minutes
Code added date: 19970101.
Code effective date: 19970101.
Pricing Indicator Code(s): 46 ; (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: D (A code denoting Medicare coverage status).
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L4210 - Orth dev repair/repl minor p
Long description: Repair of orthotic device, repair or replace minor parts
Code added date: 19850101.
Code effective date: 19960101.
Pricing Indicator Code(s): 46 ; (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: D (A code denoting Medicare coverage status).
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L4350 - Ankle control ortho pre ots
Long description: Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf
Code added date: 19890101.
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).
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