Knee orthosis, 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, custom fabricated
Short Description: Ko w adj flex/ext rotat mold
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1988
Effective Date: January 1, 2006
Termination Date: