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HCPCS Procedure & Supply Codes
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Orthotic Devices & Services
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Orthotic Devices -- Upper Limb
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Replace, Replacement, Repair
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L4000 | | Replace girdle for spinal orthosis (ctlso or so) |
L4002 | | Replacement strap, any orthosis, includes all components, any length, any type |
L4010 | | Replace trilateral socket brim |
L4020 | | Replace quadrilateral socket brim, molded to patient model |
L4030 | | Replace quadrilateral socket brim, custom fitted |
L4040 | | Replace molded thigh lacer, for custom fabricated orthosis only |
L4045 | | Replace non-molded thigh lacer, for custom fabricated orthosis only |
L4050 | | Replace molded calf lacer, for custom fabricated orthosis only |
L4055 | | Replace non-molded calf lacer, for custom fabricated orthosis only |
L4060 | | Replace high roll cuff |
L4070 | | Replace proximal and distal upright for kafo |
L4080 | | Replace metal bands kafo, proximal thigh |
L4090 | | Replace metal bands kafo-afo, calf or distal thigh |
L4100 | | Replace leather cuff kafo, proximal thigh |
L4110 | | Replace leather cuff kafo-afo, calf or distal thigh |
L4130 | | Replace pretibial shell |
L4205 | | Repair of orthotic device, labor component, per 15 minutes |
L4210 | | Repair of orthotic device, repair or replace minor parts |
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