L0174 – Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf

Long description

Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf

Short description

Cerv sr 2pc thor ext pre ots

Pricing indicator

38 Orthotics, prosthetics, prosthetic devices & vision services

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1F Prosthetic/Orthotic devices

Added

January 1, 1988

Last change

January 1, 2014 – No change

Nearby L codes

• L0113 – Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment
• L0120 – Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar)
• L0130 – Cervical, flexible, thermoplastic collar, molded to patient
• L0140 – Cervical, semi-rigid, adjustable (plastic collar)
• L0150 – Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece)
• L0160 – Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf
• L0170 – Cervical, collar, molded to patient model
• L0172 – Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf
• L0180 – Cervical, multiple post collar, occipital/mandibular supports, adjustable
• L0190 – Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types)
• L0200 – Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension
• L0220 – Thoracic, rib belt, custom fabricated
• L0450 – Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf
• L0452 – Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated
• L0454 – Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L0455 – Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf