HCPCS Code L0486

Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
Short DescriptionTlso rigidlined cust fab two
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2003
Code Added DateJanuary 01, 2003
Pricing Indicator38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Type of ServiceP = Lump sum purchase of DME, prosthetics, orthotics