2025 HCPCS Code L0491

Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

TAGS: stabilizing motion anterior fitting spinal provided symphysis overlapping segmented straps inferior sagittal sacrococcygeal coronal junction lateral terminates gross pubis extends restricts plastic rigid scapular strength modular posterior trunk adjustment
Short DescriptionTlso 2 piece rigid shell
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date January 01, 2006
HCPCS Action Effective Date January 01, 2006
HCPCS Pricing Indicator Code 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
HCPCS Type Of Service Code P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Multiple Pricing Indicator Code A - Not applicable as HCPCS priced under one methodology
HCPCS Anesthesia Base Unit Quantity 0
HCPCS Coverage Issues Manual Reference Section Number

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