HCPCS Code L0490
Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment
| Short Description | Tlso rigid plastic pre one |
|---|---|
| Year | 2026 |
| Coverage Code | C = Carrier judgment |
| Action Code | N = No maintenance for this code |
| Action Effective Date | January 01, 2003 |
| Code Added Date | January 01, 2003 |
| Pricing Indicator | 38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| Type of Service | P = Lump sum purchase of DME, prosthetics, orthotics |