Addition to tlso, (low profile), lumbar derotation pad
Short Description: Lumbar derotation pad
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1988
Effective Date: January 1, 1996
Termination Date:
Short Description: Lumbar derotation pad
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1988
Effective Date: January 1, 1996
Termination Date: