| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
L0457 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf |
| HCPCS Short Description |
Tlso flex trnk sj-ss pre ots |
| HCPCS Pricing Indicator Code 1 |
38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Code |
C - Carrier judgment |
| HCPCS Berenson-Eggers Type Of Service Code |
D1F - Prosthetic/Orthotic devices |
| HCPCS Type Of Service Code 1 |
P - Lump sum purchase of DME, prosthetics, orthotics |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2014 |
| HCPCS Action Effective Date |
1/1/2014 |
| HCPCS Action Code |
N - No maintenance for this code |