HCPCS L0490 Code. Tlso rigid plastic pre one


Table of content for "Tlso rigid plastic pre one" (HCPCS L0490)

General information on the “L0490” code

HCPCS Code: L0490
Long Description: Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
Short Description: Tlso rigid plastic pre one

Original information is taken from L0490 page

Pricing indicators

Pricing Indicator Code 1: 38 – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) . Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology

Certification and additional reference information

Coverage

Coverage: C – Carrier judgment

Type of service


Berenson-Eggers Type of Service (BETOS): D1F – Prosthetic/Orthotic devices
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics

Misc information

Anesthesia Base Unit Quantity: 0
Code Added Date: 20030101
Code Effective Date: 20030101
Action Code: N – No maintenance for this code