HCPCS Code: L3000
Short Description: Ft insert ucb berkeley shell
Long Description: Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each
HCPCS Code: L3001
Short Description: Foot insert remov molded spe
Long Description: Foot, insert, removable, molded to patient model, spenco, each
HCPCS Code: L3002
Short Description: Foot insert plastazote or eq
Long Description: Foot, insert, removable, molded to patient model, plastazote or equal, each
HCPCS Code: L3003
Short Description: Foot insert silicone gel eac
Long Description: Foot, insert, removable, molded to patient model, silicone gel, each
HCPCS Code: L3010
Short Description: Foot longitudinal arch suppo
Long Description: Foot, insert, removable, molded to patient model, longitudinal arch support, each
HCPCS Code: L3020
Short Description: Foot longitud/metatarsal sup
Long Description: Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each
HCPCS Code: L3030
Short Description: Foot arch support remov prem
Long Description: Foot, insert, removable, formed to patient foot, each
HCPCS Code: L3031
Short Description: Foot lamin/prepreg composite
Long Description: Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each
HCPCS Code: L3040
Short Description: Ft arch suprt premold longit
Long Description: Foot, arch support, removable, premolded, longitudinal, each
HCPCS Code: L3050
Short Description: Foot arch supp premold metat
Long Description: Foot, arch support, removable, premolded, metatarsal, each
HCPCS Code: L3060
Short Description: Foot arch supp longitud/meta
Long Description: Foot, arch support, removable, premolded, longitudinal/ metatarsal, each
HCPCS Code: L3070
Short Description: Arch suprt att to sho longit
Long Description: Foot, arch support, non-removable attached to shoe, longitudinal, each
HCPCS Code: L3080
Short Description: Arch supp att to shoe metata
Long Description: Foot, arch support, non-removable attached to shoe, metatarsal, each
HCPCS Code: L3090
Short Description: Arch supp att to shoe long/m
Long Description: Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each
HCPCS Code: L3100
Short Description: Hallus-valgus nt dyn pre ots
Long Description: Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
HCPCS Code: L3140
Short Description: Abduction rotation bar shoe
Long Description: Foot, abduction rotation bar, including shoes
HCPCS Code: L3150
Short Description: Abduct rotation bar w/o shoe
Long Description: Foot, abduction rotation bar, without shoes
HCPCS Code: L3160
Short Description: Shoe styled positioning dev
Long Description: Foot, adjustable shoe-styled positioning device
HCPCS Code: L3170
Short Description: Foot plas heel stabi pre ots
Long Description: Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each
HCPCS Code: L3201
Short Description: Oxford w supinat/pronat inf
Long Description: Orthopedic shoe, oxford with supinator or pronator, infant
HCPCS Code: L3202
Short Description: Oxford w/ supinat/pronator c
Long Description: Orthopedic shoe, oxford with supinator or pronator, child
HCPCS Code: L3203
Short Description: Oxford w/ supinator/pronator
Long Description: Orthopedic shoe, oxford with supinator or pronator, junior
HCPCS Code: L3204
Short Description: Hightop w/ supp/pronator inf
Long Description: Orthopedic shoe, hightop with supinator or pronator, infant
HCPCS Code: L3206
Short Description: Hightop w/ supp/pronator chi
Long Description: Orthopedic shoe, hightop with supinator or pronator, child
HCPCS Code: L3207
Short Description: Hightop w/ supp/pronator jun
Long Description: Orthopedic shoe, hightop with supinator or pronator, junior
HCPCS Code: L3208
Short Description: Surgical boot each infant
Long Description: Surgical boot, each, infant
HCPCS Code: L3209
Short Description: Surgical boot each child
Long Description: Surgical boot, each, child
HCPCS Code: L3211
Short Description: Surgical boot each junior
Long Description: Surgical boot, each, junior
HCPCS Code: L3212
Short Description: Benesch boot pair infant
Long Description: Benesch boot, pair, infant
HCPCS Code: L3213
Short Description: Benesch boot pair child
Long Description: Benesch boot, pair, child
HCPCS Code: L3214
Short Description: Benesch boot pair junior
Long Description: Benesch boot, pair, junior
HCPCS Code: L3215
Short Description: Orthopedic ftwear ladies oxf
Long Description: Orthopedic footwear, ladies shoe, oxford, each
HCPCS Code: L3216
Short Description: Orthoped ladies shoes dpth i
Long Description: Orthopedic footwear, ladies shoe, depth inlay, each
HCPCS Code: L3217
Short Description: Ladies shoes hightop depth i
Long Description: Orthopedic footwear, ladies shoe, hightop, depth inlay, each
HCPCS Code: L3219
Short Description: Orthopedic mens shoes oxford
Long Description: Orthopedic footwear, mens shoe, oxford, each
HCPCS Code: L3221
Short Description: Orthopedic mens shoes dpth i
Long Description: Orthopedic footwear, mens shoe, depth inlay, each
HCPCS Code: L3222
Short Description: Mens shoes hightop depth inl
Long Description: Orthopedic footwear, mens shoe, hightop, depth inlay, each
HCPCS Code: L3224
Short Description: Woman's shoe oxford brace
Long Description: Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis)
HCPCS Code: L3225
Short Description: Man's shoe oxford brace
Long Description: Orthopedic footwear, man's shoe, oxford, used as an integral part of a brace (orthosis)
HCPCS Code: L3230
Short Description: Custom shoes depth inlay
Long Description: Orthopedic footwear, custom shoe, depth inlay, each
HCPCS Code: L3250
Short Description: Custom mold shoe remov prost
Long Description: Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each
HCPCS Code: L3251
Short Description: Shoe molded to pt silicone s
Long Description: Foot, shoe molded to patient model, silicone shoe, each
HCPCS Code: L3252
Short Description: Shoe molded plastazote cust
Long Description: Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each
HCPCS Code: L3253
Short Description: Shoe molded plastazote cust
Long Description: Foot, molded shoe plastazote (or similar) custom fitted, each
HCPCS Code: L3254
Short Description: Orth foot non-stndard size/w
Long Description: Non-standard size or width
HCPCS Code: L3255
Short Description: Orth foot non-standard size/
Long Description: Non-standard size or length
HCPCS Code: L3257
Short Description: Orth foot add charge split s
Long Description: Orthopedic footwear, additional charge for split size
HCPCS Code: L3260
Short Description: Ambulatory surgical boot eac
Long Description: Surgical boot/shoe, each
HCPCS Code: L3265
Short Description: Plastazote sandal each
Long Description: Plastazote sandal, each
HCPCS Code: L3300
Short Description: Sho lift taper to metatarsal
Long Description: Lift, elevation, heel, tapered to metatarsals, per inch
HCPCS Code: L3310
Short Description: Shoe lift elev heel/sole neo
Long Description: Lift, elevation, heel and sole, neoprene, per inch
HCPCS Code: L3320
Short Description: Shoe lift elev heel/sole cor
Long Description: Lift, elevation, heel and sole, cork, per inch
HCPCS Code: L3330
Short Description: Lifts elevation metal extens
Long Description: Lift, elevation, metal extension (skate)
HCPCS Code: L3332
Short Description: Shoe lifts tapered to one-ha
Long Description: Lift, elevation, inside shoe, tapered, up to one-half inch
HCPCS Code: L3334
Short Description: Shoe lifts elevation heel /i
Long Description: Lift, elevation, heel, per inch
HCPCS Code: L3340
Short Description: Shoe wedge sach
Long Description: Heel wedge, sach
HCPCS Code: L3350
Short Description: Shoe heel wedge
Long Description: Heel wedge
HCPCS Code: L3360
Short Description: Shoe sole wedge outside sole
Long Description: Sole wedge, outside sole
HCPCS Code: L3370
Short Description: Shoe sole wedge between sole
Long Description: Sole wedge, between sole
HCPCS Code: L3380
Short Description: Shoe clubfoot wedge
Long Description: Clubfoot wedge
HCPCS Code: L3390
Short Description: Shoe outflare wedge
Long Description: Outflare wedge
HCPCS Code: L3400
Short Description: Shoe metatarsal bar wedge ro
Long Description: Metatarsal bar wedge, rocker
HCPCS Code: L3410
Short Description: Shoe metatarsal bar between
Long Description: Metatarsal bar wedge, between sole
HCPCS Code: L3420
Short Description: Full sole/heel wedge btween
Long Description: Full sole and heel wedge, between sole
HCPCS Code: L3430
Short Description: Sho heel count plast reinfor
Long Description: Heel, counter, plastic reinforced
HCPCS Code: L3440
Short Description: Heel leather reinforced
Long Description: Heel, counter, leather reinforced
HCPCS Code: L3450
Short Description: Shoe heel sach cushion type
Long Description: Heel, sach cushion type
HCPCS Code: L3455
Short Description: Shoe heel new leather standa
Long Description: Heel, new leather, standard
HCPCS Code: L3460
Short Description: Shoe heel new rubber standar
Long Description: Heel, new rubber, standard
HCPCS Code: L3465
Short Description: Shoe heel thomas with wedge
Long Description: Heel, thomas with wedge
HCPCS Code: L3470
Short Description: Shoe heel thomas extend to b
Long Description: Heel, thomas extended to ball
HCPCS Code: L3480
Short Description: Shoe heel pad & depress for
Long Description: Heel, pad and depression for spur
HCPCS Code: L3485
Short Description: Shoe heel pad removable for
Long Description: Heel, pad, removable for spur
HCPCS Code: L3500
Short Description: Ortho shoe add leather insol
Long Description: Orthopedic shoe addition, insole, leather
HCPCS Code: L3510
Short Description: Orthopedic shoe add rub insl
Long Description: Orthopedic shoe addition, insole, rubber
HCPCS Code: L3520
Short Description: O shoe add felt w leath insl
Long Description: Orthopedic shoe addition, insole, felt covered with leather
HCPCS Code: L3530
Short Description: Ortho shoe add half sole
Long Description: Orthopedic shoe addition, sole, half
HCPCS Code: L3540
Short Description: Ortho shoe add full sole
Long Description: Orthopedic shoe addition, sole, full
HCPCS Code: L3550
Short Description: O shoe add standard toe tap
Long Description: Orthopedic shoe addition, toe tap standard
HCPCS Code: L3560
Short Description: O shoe add horseshoe toe tap
Long Description: Orthopedic shoe addition, toe tap, horseshoe
HCPCS Code: L3570
Short Description: O shoe add instep extension
Long Description: Orthopedic shoe addition, special extension to instep (leather with eyelets)
HCPCS Code: L3580
Short Description: O shoe add instep velcro clo
Long Description: Orthopedic shoe addition, convert instep to velcro closure
HCPCS Code: L3590
Short Description: O shoe convert to sof counte
Long Description: Orthopedic shoe addition, convert firm shoe counter to soft counter
HCPCS Code: L3595
Short Description: Ortho shoe add march bar
Long Description: Orthopedic shoe addition, march bar
HCPCS Code: L3600
Short Description: Trans shoe calip plate exist
Long Description: Transfer of an orthosis from one shoe to another, caliper plate, existing
HCPCS Code: L3610
Short Description: Trans shoe caliper plate new
Long Description: Transfer of an orthosis from one shoe to another, caliper plate, new
HCPCS Code: L3620
Short Description: Trans shoe solid stirrup exi
Long Description: Transfer of an orthosis from one shoe to another, solid stirrup, existing
HCPCS Code: L3630
Short Description: Trans shoe solid stirrup new
Long Description: Transfer of an orthosis from one shoe to another, solid stirrup, new
HCPCS Code: L3640
Short Description: Shoe dennis browne splint bo
Long Description: Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes
HCPCS Code: L3649
Short Description: Orthopedic shoe modifica nos
Long Description: Orthopedic shoe, modification, addition or transfer, not otherwise specified
HCPCS Code: L3650
Short Description: So 8 abd restraint pre ots
Long Description: Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf
HCPCS Code: L3660
Short Description: So 8 ab rstr can/web pre ots
Long Description: Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf
HCPCS Code: L3670
Short Description: So acro/clav can web pre ots
Long Description: Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf
HCPCS Code: L3671
Short Description: So cap design w/o jnts cf
Long Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3674
Short Description: So airplane w/wo joint cf
Long Description: Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3675
Short Description: So vest canvas/web pre ots
Long Description: Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf
HCPCS Code: L3677
Short Description: So hard plas stabili pre cst
Long Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Code: L3678
Short Description: So hard plas stabili pre ots
Long Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf
HCPCS Code: L3702
Short Description: Eo w/o joints cf
Long Description: Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3710
Short Description: Eo elas w/metal jnts pre ots
Long Description: Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf
HCPCS Code: L3720
Short Description: Forearm/arm cuffs free motio
Long Description: Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated
HCPCS Code: L3730
Short Description: Forearm/arm cuffs ext/flex a
Long Description: Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated
HCPCS Code: L3740
Short Description: Cuffs adj lock w/ active con
Long Description: Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated
HCPCS Code: L3760
Short Description: Eo adj jt prefab custom fit
Long Description: Elbow orthosis (eo), with adjustable position locking joint(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: L3761
Short Description: Eo, adj lock joint prefab ot
Long Description: Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf
HCPCS Code: L3762
Short Description: Eo rigid w/o joints pre ots
Long Description: Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf
HCPCS Code: L3763
Short Description: Ewho rigid w/o jnts cf
Long Description: Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3764
Short Description: Ewho w/joint(s) cf
Long Description: Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3765
Short Description: Ewhfo rigid w/o jnts cf
Long Description: Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3766
Short Description: Ewhfo w/joint(s) cf
Long Description: Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3806
Short Description: Whfo w/joint(s) custom fab
Long Description: Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3807
Short Description: Whfo w/o joints pre cst
Long Description: Wrist hand finger orthosis, without joint(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: L3808
Short Description: Whfo, rigid w/o joints
Long Description: Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3809
Short Description: Whfo w/o joints pre ots
Long Description: Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type
HCPCS Code: L3891
Short Description: Torsion mechanism wrist/elbo
Long Description: Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each
HCPCS Code: L3900
Short Description: Hinge extension/flex wrist/f
Long Description: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated
HCPCS Code: L3901
Short Description: Hinge ext/flex wrist finger
Long Description: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated
HCPCS Code: L3904
Short Description: Whfo electric custom fitted
Long Description: Wrist hand finger orthosis, external powered, electric, custom fabricated
HCPCS Code: L3905
Short Description: Who w/nontorsion jnt(s) cf
Long Description: Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3906
Short Description: Who w/o joints cf
Long Description: Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3908
Short Description: Who cock-up nonmolde pre ots
Long Description: Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf
HCPCS Code: L3912
Short Description: Hfo flexion glove pre ots
Long Description: Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf
HCPCS Code: L3913
Short Description: Hfo w/o joints cf
Long Description: Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3915
Short Description: Who nontorsion jnts pre cst
Long Description: Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Code: L3916
Short Description: Who nontorsion jnts pre ots
Long Description: Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf
HCPCS Code: L3917
Short Description: Metacarp fx orthosis pre cst
Long Description: Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Code: L3918
Short Description: Metacarp fx orthosis pre ots
Long Description: Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf
HCPCS Code: L3919
Short Description: Ho w/o joints cf
Long Description: Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3921
Short Description: Hfo w/joint(s) cf
Long Description: Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3923
Short Description: Hfo without joints pre cst
Long Description: Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Code: L3924
Short Description: Hfo without joints pre ots
Long Description: Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf
HCPCS Code: L3925
Short Description: Fo pip dip jnt/sprng pre ots
Long Description: Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf
HCPCS Code: L3927
Short Description: Fo pip dip no jt spr pre ots
Long Description: Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf
HCPCS Code: L3929
Short Description: Hfo nontorsion jnts pre cst
Long Description: Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
HCPCS Code: L3930
Short Description: Hfo nontorsion jnts pre ots
Long Description: Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf
HCPCS Code: L3931
Short Description: Whfo nontorsion joint prefab
Long Description: Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment
HCPCS Code: L3933
Short Description: Fo w/o joints cf
Long Description: Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment
HCPCS Code: L3935
Short Description: Fo nontorsion joint cf
Long Description: Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment
HCPCS Code: L3956
Short Description: Add joint upper ext orthosis
Long Description: Addition of joint to upper extremity orthosis, any material; per joint
HCPCS Code: L3960
Short Description: Sewho airplan desig abdu pos
Long Description: Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment
HCPCS Code: L3961
Short Description: Sewho cap design w/o jnts cf
Long Description: Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3962
Short Description: Sewho erbs palsey design abd
Long Description: Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment
HCPCS Code: L3967
Short Description: Sewho airplane w/o jnts cf
Long Description: Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
HCPCS Code: L3971
Short Description: 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
HCPCS Code: L3973
Short Description: 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
HCPCS Code: L3975
Short Description: 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
HCPCS Code: L3976
Short Description: 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
HCPCS Code: L3977
Short Description: 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
HCPCS Code: L3978
Short Description: 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
HCPCS Code: L3980
Short Description: Up ext fx orthos humeral nos
Long Description: Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment
HCPCS Code: L3981
Short Description: 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
HCPCS Code: L3982
Short Description: Upper ext fx orthosis rad/ul
Long Description: Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
HCPCS Code: L3984
Short Description: Upper ext fx orthosis wrist
Long Description: Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment
HCPCS Code: L3995
Short Description: Sock fracture or equal each
Long Description: Addition to upper extremity orthosis, sock, fracture or equal, each
HCPCS Code: L3999
Short Description: Upper limb orthosis nos
Long Description: Upper limb orthosis, not otherwise specified