HCPCS code L0484 — Tlso rigid plastic cust fab.
Status: Active.
Effective Jan 1, 2003.
Source: CMS HCPCS Level II.
L0484
ActiveTlso rigid plastic cust fab
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
Category:
Orthotics & Prosthetics
Section:
L-codes: Orthotic and Prosthetic Procedures
Effective:
Jan 1, 2003
Code type:
alphanumeric
OPPS Status:
A
— Paid under a separate fee schedule (not OPPS)
MUE — Medically Unlikely Edits
Maximum units of L0484 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| DME Supplier | 1 |
| Outpatient Hospital | 1 |
| Practitioner Services | 0 |
Source: CMS Medicare NCCI Medically Unlikely Edits