L0452-Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated
The following add-on codes may be used for this base code (only code for what you use):
Custom TLSO Additions
L0974- Tlso full corset
L0978- Axillary crutch extension
L1240- Lumbar derotation pad
L1250- Addition to tlso, (low profile), anterior asis pad
L1260- Addition to tlso, (low profile), anterior thoracic derotation pad
L1290- Addition to tlso, (low profile), lateral trochanteric pad
Custom or Prefab TLSO Additions
L0980- Peroneal straps, prefabricated, off-the-shelf, pair
L0982- Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)
L0984- Protective body sock, prefabricated, off-the-shelf, each
One or more of the following criteria should be met for the spinal orthosis to be covered by Medicare.
1. To reduce pain by restricting mobility of the trunk
2. To facilitate healing following an injury to the spine or related soft tissues
3. To facilitate healing following a surgical procedure on the spine or related soft tissue
4. To otherwise support weak SPINAL muscles and/or a deformed spine
L0454-Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
L0455-Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
The following add-on codes may be used for this base code (only code for what you use):
Custom or OTS TLSO Additions
L0980- Peroneal straps, prefabricated, off-the-shelf, pair
L0982- Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)
L0984- Protective body sock, prefabricated, off-the-shelf, each
L0456-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 item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
The following add-on codes may be used for this base code (only code for what you use):
Any TLSO Additions
L0980- Peroneal straps, prefabricated, off-the-shelf, pair
L0982- Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)
L0984- Protective body sock, prefabricated, off-the-shelf, each
L0457-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
The following add-on codes may be used for this base code (only code for what you use):
Custom or OTS TLSO Additions
L0980- Peroneal straps, prefabricated, off-the-shelf, pair
L0982- Stocking supporter grips, prefabricated, off-the-shelf, set of four (4)
L0984- Protective body sock, prefabricated, off-the-shelf, each