L1852

Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

Short Description: Ko double upright prefab ots

Coverage Code: Carrier judgment

Action Code: No maintenance for this code

Date Added: January 1, 2017

Effective Date: January 1, 2017

Termination Date:

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