List of HCPCS codes for: Orthotic/Prosthetic Procedures (L-codes) - Group L1



HCPCS Code: L1
Short Description: Separately payable lab test
Long Description: Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps

HCPCS Code: L1000
Short Description: Ctlso milwauke initial model
Long Description: Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model

HCPCS Code: L1001
Short Description: Ctlso infant immobilizer
Long Description: Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment

HCPCS Code: L1005
Short Description: Tension based scoliosis orth
Long Description: Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment

HCPCS Code: L1010
Short Description: Ctlso axilla sling
Long Description: Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling

HCPCS Code: L1020
Short Description: Kyphosis pad
Long Description: Addition to ctlso or scoliosis orthosis, kyphosis pad

HCPCS Code: L1025
Short Description: Kyphosis pad floating
Long Description: Addition to ctlso or scoliosis orthosis, kyphosis pad, floating

HCPCS Code: L1030
Short Description: Lumbar bolster pad
Long Description: Addition to ctlso or scoliosis orthosis, lumbar bolster pad

HCPCS Code: L1040
Short Description: Lumbar or lumbar rib pad
Long Description: Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad

HCPCS Code: L1050
Short Description: Sternal pad
Long Description: Addition to ctlso or scoliosis orthosis, sternal pad

HCPCS Code: L1060
Short Description: Thoracic pad
Long Description: Addition to ctlso or scoliosis orthosis, thoracic pad

HCPCS Code: L1070
Short Description: Trapezius sling
Long Description: Addition to ctlso or scoliosis orthosis, trapezius sling

HCPCS Code: L1080
Short Description: Outrigger
Long Description: Addition to ctlso or scoliosis orthosis, outrigger

HCPCS Code: L1085
Short Description: Outrigger bil w/ vert extens
Long Description: Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions

HCPCS Code: L1090
Short Description: Lumbar sling
Long Description: Addition to ctlso or scoliosis orthosis, lumbar sling

HCPCS Code: L1100
Short Description: Ring flange plastic/leather
Long Description: Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather

HCPCS Code: L1110
Short Description: Ring flange plas/leather mol
Long Description: Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model

HCPCS Code: L1120
Short Description: Covers for upright each
Long Description: Addition to ctlso, scoliosis orthosis, cover for upright, each

HCPCS Code: L1200
Short Description: Furnsh initial orthosis only
Long Description: Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only

HCPCS Code: L1210
Short Description: Lateral thoracic extension
Long Description: Addition to tlso, (low profile), lateral thoracic extension

HCPCS Code: L1220
Short Description: Anterior thoracic extension
Long Description: Addition to tlso, (low profile), anterior thoracic extension

HCPCS Code: L1230
Short Description: Milwaukee type superstructur
Long Description: Addition to tlso, (low profile), milwaukee type superstructure

HCPCS Code: L1240
Short Description: Lumbar derotation pad
Long Description: Addition to tlso, (low profile), lumbar derotation pad

HCPCS Code: L1250
Short Description: Anterior asis pad
Long Description: Addition to tlso, (low profile), anterior asis pad

HCPCS Code: L1260
Short Description: Anterior thoracic derotation
Long Description: Addition to tlso, (low profile), anterior thoracic derotation pad

HCPCS Code: L1270
Short Description: Abdominal pad
Long Description: Addition to tlso, (low profile), abdominal pad

HCPCS Code: L1280
Short Description: Rib gusset (elastic) each
Long Description: Addition to tlso, (low profile), rib gusset (elastic), each

HCPCS Code: L1290
Short Description: Lateral trochanteric pad
Long Description: Addition to tlso, (low profile), lateral trochanteric pad

HCPCS Code: L1300
Short Description: Body jacket mold to patient
Long Description: Other scoliosis procedure, body jacket molded to patient model

HCPCS Code: L1310
Short Description: Post-operative body jacket
Long Description: Other scoliosis procedure, post-operative body jacket

HCPCS Code: L1499
Short Description: Spinal orthosis nos
Long Description: Spinal orthosis, not otherwise specified

HCPCS Code: L1600
Short Description: Ho flex frejka w/cov pre cst
Long Description: Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise

HCPCS Code: L1610
Short Description: Ho frejka cov only pre cst
Long Description: Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1620
Short Description: Ho flex pavlik harns pre cst
Long Description: Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1630
Short Description: Abduct control hip semi-flex
Long Description: Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated

HCPCS Code: L1640
Short Description: Pelv band/spread bar thigh c
Long Description: Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated

HCPCS Code: L1650
Short Description: Ho abduction hip adjustable
Long Description: Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment

HCPCS Code: L1652
Short Description: Ho bi thighcuffs w sprdr bar
Long Description: Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type

HCPCS Code: L1660
Short Description: Ho abduction static plastic
Long Description: Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment

HCPCS Code: L1680
Short Description: Pelvic & hip control thigh c
Long Description: Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated

HCPCS Code: L1685
Short Description: Post-op hip abduct custom fa
Long Description: Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated

HCPCS Code: L1686
Short Description: Ho post-op hip abduction
Long Description: Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment

HCPCS Code: L1690
Short Description: Combination bilateral ho
Long Description: Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment

HCPCS Code: L1700
Short Description: Leg perthes orth toronto typ
Long Description: Legg perthes orthosis, (toronto type), custom fabricated

HCPCS Code: L1710
Short Description: Legg perthes orth newington
Long Description: Legg perthes orthosis, (newington type), custom fabricated

HCPCS Code: L1720
Short Description: Legg perthes orthosis trilat
Long Description: Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated

HCPCS Code: L1730
Short Description: Legg perthes orth scottish r
Long Description: Legg perthes orthosis, (scottish rite type), custom fabricated

HCPCS Code: L1755
Short Description: Legg perthes patten bottom t
Long Description: Legg perthes orthosis, (patten bottom type), custom fabricated

HCPCS Code: L1810
Short Description: Ko elastic with joints
Long Description: Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1812
Short Description: Ko elastic w/joints pre ots
Long Description: Knee orthosis, elastic with joints, prefabricated, off-the-shelf

HCPCS Code: L1820
Short Description: Ko elas w/ condyle pads & jo
Long Description: Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment

HCPCS Code: L1830
Short Description: Ko immob canvas long pre ots
Long Description: Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf

HCPCS Code: L1831
Short Description: Knee orth pos locking joint
Long Description: Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment

HCPCS Code: L1832
Short Description: Ko adj jnt pos r sup pre cst
Long Description: Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1833
Short Description: Ko adj jnt pos r sup pre ots
Long Description: Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf

HCPCS Code: L1834
Short Description: Ko w/0 joint rigid molded to
Long Description: Knee orthosis, without knee joint, rigid, custom fabricated

HCPCS Code: L1836
Short Description: Ko rigid w/o joints pre ots
Long Description: Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf

HCPCS Code: L1840
Short Description: Ko derot ant cruciate custom
Long Description: Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated

HCPCS Code: L1843
Short Description: Ko single upright pre cst
Long Description: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1844
Short Description: Ko w/adj jt rot cntrl molded
Long Description: Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated

HCPCS Code: L1845
Short Description: Ko double upright pre cst
Long Description: Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1846
Short Description: Ko w adj flex/ext rotat mold
Long Description: Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated

HCPCS Code: L1847
Short Description: Ko dbl upright w/air pre cst
Long Description: Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1848
Short Description: Ko dbl upright w/air pre ots
Long Description: Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf

HCPCS Code: L1850
Short Description: Ko swedish type pre ots
Long Description: Knee orthosis, swedish type, prefabricated, off-the-shelf

HCPCS Code: L1860
Short Description: Ko supracondylar socket mold
Long Description: Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)

HCPCS Code: L1900
Short Description: Afo sprng wir drsflx calf bd
Long Description: Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated

HCPCS Code: L1902
Short Description: Afo ankle gauntlet pre ots
Long Description: Ankle orthosis, ankle gauntlet or similiar, with or without joints, prefabricated, off-the-shelf

HCPCS Code: L1904
Short Description: Afo molded ankle gauntlet
Long Description: Ankle orthosis, ankle gauntlet or similiar, with or without joints, custom fabricated

HCPCS Code: L1906
Short Description: Afo multilig ank sup pre ots
Long Description: Ankle foot orthosis, multiligamentus ankle support, prefabricated, off-the-shelf

HCPCS Code: L1907
Short Description: Afo supramalleolar custom
Long Description: Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated

HCPCS Code: L1910
Short Description: Afo sing bar clasp attach sh
Long Description: Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment

HCPCS Code: L1920
Short Description: Afo sing upright w/ adjust s
Long Description: Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated

HCPCS Code: L1930
Short Description: Afo plastic
Long Description: Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment

HCPCS Code: L1932
Short Description: Afo rig ant tib prefab tcf/=
Long Description: Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment

HCPCS Code: L1940
Short Description: Afo molded to patient plasti
Long Description: Ankle foot orthosis, plastic or other material, custom fabricated

HCPCS Code: L1945
Short Description: Afo molded plas rig ant tib
Long Description: Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated

HCPCS Code: L1950
Short Description: Afo spiral molded to pt plas
Long Description: Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated

HCPCS Code: L1951
Short Description: Afo spiral prefabricated
Long Description: Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment

HCPCS Code: L1960
Short Description: Afo pos solid ank plastic mo
Long Description: Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated

HCPCS Code: L1970
Short Description: Afo plastic molded w/ankle j
Long Description: Ankle foot orthosis, plastic with ankle joint, custom fabricated

HCPCS Code: L1971
Short Description: Afo w/ankle joint, prefab
Long Description: Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment

HCPCS Code: L1980
Short Description: Afo sing solid stirrup calf
Long Description: Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated

HCPCS Code: L1990
Short Description: Afo doub solid stirrup calf
Long Description: Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated