| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L6624 |
Upper extremity addition, flexion/extension and rotation wrist unit |
98 |
64 |
$4K |
| L6205 |
Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm |
93 |
47 |
$2K |
| L1690 |
Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment |
48 |
44 |
$2K |
| L0710 |
Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type) |
50 |
46 |
$1K |
| L3904 |
Wrist hand finger orthosis, external powered, electric, custom fabricated |
86 |
44 |
$1K |
| L3730 |
Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated |
93 |
47 |
$698.28 |
| 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 |
89 |
57 |
$0.00 |
| L0170 |
Cervical, collar, molded to patient model |
51 |
47 |
$0.00 |
| L2005 |
Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated |
86 |
56 |
$0.00 |
| L1005 |
Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment |
51 |
49 |
$0.00 |
| L0636 |
Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, 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, anterior panel, pendulous abdomen design, custom fabricated |
45 |
43 |
$0.00 |
| L0830 |
Halo procedure, cervical halo incorporated into milwaukee type orthosis |
53 |
49 |
$0.00 |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
85 |
57 |
$0.00 |
| L1710 |
Legg perthes orthosis, (newington type), custom fabricated |
90 |
46 |
$0.00 |