HCPCS Code L1852

Knee orthosis (ko), 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, prefabricated, off-the-shelf
Short DescriptionKo double upright prefab ots
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2017
Code Added DateJanuary 01, 2017
Pricing Indicator38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Type of ServiceP = Lump sum purchase of DME, prosthetics, orthotics