L3999 – Upper limb orthosis, not otherwise specified

Long description

Upper limb orthosis, not otherwise specified

Short description

Upper limb orthosis nos

Pricing indicator

46 Priced by carrier (not otherwise classified / individual determination)

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1F Prosthetic/Orthotic devices

Added

January 1, 1982

Last change

January 1, 1998 – No change

Nearby L codes

• L3976 – Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3977 – Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3978 – Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment
• L3980 – Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment
• L3981 – Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments
• L3982 – Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment
• L3984 – Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment
• L3995 – Addition to upper extremity orthosis, sock, fracture or equal, each
• L4000 – Replace girdle for spinal orthosis (ctlso or so)
• L4002 – Replacement strap, any orthosis, includes all components, any length, any type
• L4010 – Replace trilateral socket brim
• L4020 – Replace quadrilateral socket brim, molded to patient model
• L4030 – Replace quadrilateral socket brim, custom fitted
• L4040 – Replace molded thigh lacer, for custom fabricated orthosis only
• L4045 – Replace non-molded thigh lacer, for custom fabricated orthosis only
• L4050 – Replace molded calf lacer, for custom fabricated orthosis only