Field Name |
Field Value |
Healthcare Common Procedure Coding System Code |
L0480 |
HCPCS Sequence Number |
0010 |
HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
HCPCS Long Description |
Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated |
HCPCS Short Description |
Tlso rigid plastic custom fa |
HCPCS Pricing Indicator Code 1 |
38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
HCPCS Coverage Code |
C - Carrier judgment |
HCPCS Berenson-Eggers Type Of Service Code |
D1F - Prosthetic/Orthotic devices |
HCPCS Type Of Service Code 1 |
P - Lump sum purchase of DME, prosthetics, orthotics |
HCPCS Anesthesia Base Unit Quantity |
0 |
HCPCS Code Added Date |
1/1/2003 |
HCPCS Action Effective Date |
1/1/2004 |
HCPCS Action Code |
N - No maintenance for this code |