HCPCS code L0490 — Tlso rigid plastic pre one.
Status: Active.
Effective Jan 1, 2003.
Source: CMS HCPCS Level II.
L0490
ActiveTlso rigid plastic pre one
Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
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 L0490 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