Braces; trusses; and artifical legs, arms, and eyes are covered when furnished incident to a physician’s services or on a physician’s order. A brace includes rigid and semirigid devices used for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body. Back braces include, but are not limited to, sacroiliac, sacrolumbar, dorsolumbar corsets, and belts. Stump stockings and harnesses (including replacements) are also covered when these appliances are essential to the effective use of an artificial limb. Adjustments to an artificial limb or other appliance required by wear or by a change in the patient’s condition are covered when ordered by a physician. Adjustments, repairs, and replacements are covered so long as the device continues to be medically required.
Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra,
lateral strength provided by rigid lateral frame/panels, produces intracavitary
pressure to reduce load on intervertebral discs, includes straps, closures, may
include padding, stays, shoulder straps, pendulous abdomen design,
prefabricated item that has been trimmed, bent, molded, assembled, or otherwise
customized to fit a specific patient by an individual with expertise
Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine,
posterior extends from sacrococcygeal junction to t-9 vertebra, lateral
strength provided by rigid lateral frame/panel(s), produces intracavitary
pressure to reduce load on intervertebral discs, includes straps, closures, may
include padding, anterior panel, pendulous abdomen design, prefabricated,
includes fitting and adjustment
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9
vertebra, lateral strength provided by rigid lateral frame/panels, produces
intracavitary pressure to reduce load on intervertebral discs, includes straps,
closures, may include padding, shoulder straps, pendulous abdomen design,
prefabricated item that has been trimmed, bent, molded, assembled, or otherwise
customized to fit a specific patient by an individual with expertise
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9
vertebra, lateral strength provided by rigid lateral frame/panels, produces
intracavitary pressure to reduce load on intervertebral discs, includes straps,
closures, may include padding, shoulder straps, pendulous abdomen design,
custom fabricated
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior
extends from symphysis pubis to xyphoid, produces intracavitary pressure to
reduce load on the intervertebral discs, overall strength is provided by
overlapping rigid material and stabilizing closures, includes straps, closures,
may include soft interface, pendulous abdomen design, prefabricated item that
has been trimmed, bent, molded, assembled, or otherwise customized to fit a
specific patient by an individual with expertise
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior
extends from symphysis pubis to xyphoid, produces intracavitary pressure to
reduce load on the intervertebral discs, overall strength is provided by
overlapping rigid material and stabilizing closures, includes straps, closures,
may include soft interface, pendulous abdomen design, custom fabricated
Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to
reduce load on the intervertebral discs, includes straps, closures, may include
padding, stays, shoulder straps, pendulous abdomen design, prefabricated,
off-the-shelf
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary
pressure to reduce load on the intervertebral discs, includes straps, closures,
may include padding, shoulder straps, pendulous abdomen design, prefabricated,
off-the-shelf
Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces
intracavitary pressure to reduce load on the intervertebral discs, includes
straps, closures, may include padding, stays, shoulder straps, pendulous
abdomen design, prefabricated, off-the-shelf
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra,
produces intracavitary pressure to reduce load on the intervertebral discs,
includes straps, closures, may include padding, shoulder straps, pendulous
abdomen design, prefabricated, off-the-shelf
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9
vertebra, lateral strength provided by rigid lateral frame/panel(s), produces
intracavitary pressure to reduce load on intervertebral discs, includes straps,
closures, may include padding, shoulder straps, pendulous abdomen design,
prefabricated, off-the-shelf
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior
extends from symphysis pubis to xyphoid, produces intracavitary pressure to
reduce load on the intervertebral discs, overall strength is provided by
overlapping rigid material and stabilizing closures, includes straps, closures,
may include soft interface, pendulous abdomen design, prefabricated,
off-the-shelf
Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, prefabricated item that has been trimmed, bent, molded, assembled, or
otherwise customized to fit a specific patient by an individual with expertise
Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla to trochanter, includes all accessory pads, straps and
interface, prefabricated item that has been trimmed, bent, molded, assembled,
or otherwise customized to fit a specific patient by an individual with
expertise
Scoliosis orthosis, sagittal-coronal control provided by a rigid lateral frame, extends from axilla, to trochanter, includes all accessory pads, straps, and
interface, custom fabricated