L0480-Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
L0480-Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, 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
L0482-Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, 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
L0484-Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, 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
L0486-Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, 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