2025 HCPCS Code 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

TAGS: customized motion expertise disks patient stays prefabricated intervertebral shoulder straps sagittal provides sacrococcygeal junction pressure gross individual extends restricts above specific reduce intracavitary rigid produces trunk
Short DescriptionTlso trnk sj-t9 pre cst
HCPCS Action Code N - No maintenance for this code
HCPCS Coverage Code C - Carrier judgment
HCPCS Code Added Date January 01, 2003
HCPCS Action Effective Date January 01, 2014
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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