HCPCS Code Section: HCPCS L Codes

Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated Short Description: Ko derot ant cruciate custom Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf Short Description: Ko rigid w/o joints pre ots Coverage Code: Carrier judgment Action Code: No maintenance for this …

Knee orthosis, without knee joint, rigid, custom fabricated Short Description: Ko w/0 joint rigid molded to Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf Short Description: Ko adj jnt pos r sup pre ots Coverage Code: Carrier judgment …

Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient …

Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment Short Description: Knee orth pos locking joint Coverage Code: Carrier judgment Action Code: No maintenance for this …

Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf Short Description: Ko immob canvas long pre ots Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January …

Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Knee orthosis, elastic with joints, prefabricated, off-the-shelf Short Description: Ko elastic w/joints pre ots Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Short Description: …