HCPCS L0491 Code. Tlso 2 piece rigid shell


Table of content for "Tlso 2 piece rigid shell" (HCPCS L0491)

General information on the “L0491” code

HCPCS Code: L0491
Long Description: Tlso, sagittal-coronal 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 and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment
Short Description: Tlso 2 piece rigid shell

Original information is taken from L0491 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: 20060101
Code Effective Date: 20060101
Action Code: N – No maintenance for this code