|
L1300 |
 |
Other scoliosis procedure, body jacket molded to patient model
| short | Body jacket mold to patient |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
|
|
|
|
L1310 |
|
Other scoliosis procedure, post-operative body jacket
| short | Post-operative body jacket |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
|
|
|
|
L1499 |
|
Spinal orthosis, not otherwise specified
| short | Spinal orthosis nos |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 1.0 | 3 Date of Service Edit: Clinical | Nature of Equipment | | OPH | 1.0 | 3 Date of Service Edit: Clinical | Nature of Equipment | | DME | 1.0 | 3 Date of Service Edit: Clinical | Nature of Equipment |
|
|
|