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HCPCS Procedure & Supply Codes

Orthotic Devices & Services

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Orthotic Devices -- Spinal

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Thoracic-Lumbar-Sacral Orthosis (TLSO)

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L0450 Tlso flex trunk/thor pre ots
L0452 Tlso flex custom fab thoraci
L0454 Tlso trnk sj-t9 pre cst
L0455 Tlso flex trnk sj-t9 pre ots
L0456 Tlso flex trnk sj-ss pre cst
L0457 Tlso flex trnk sj-ss pre ots
L0458 Tlso 2mod symphis-xipho pre
L0460 Tlso 2 shl symphys-stern cst
L0462 Tlso 3mod sacro-scap pre
L0464 Tlso 4mod sacro-scap pre
L0466 Tlso r fram soft ant pre cst
L0467 Tlso r fram soft pre ots
L0468 Tlso rig fram pelvic pre cst
L0469 Tlso rig fram pelvic pre ots
L0470 Tlso rigid frame pre subclav
L0472 Tlso rigid frame hyperex pre
L0480 Tlso rigid plastic custom fa
L0482 Tlso rigid lined custom fab
L0484 Tlso rigid plastic cust fab
L0486 Tlso rigidlined cust fab two
L0488 Tlso rigid lined pre one pie
L0490 Tlso rigid plastic pre one
L0491 Tlso 2 piece rigid shell
L0492 Tlso 3 piece rigid shell
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