L0458 Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

Short descriptor: Tlso 2mod symphis-xipho pre

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L0458 is the HCPCS Level II code for Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment (2026). It belongs to Section L — Orthotic & Prosthetic Procedures. Under Medicare, its coverage status is: Carrier judgment. Part B pricing methodology: Orthotics, prosthetics & vision services.

Classification & CMS Attributes

Medicare Coverage
Carrier judgment (code C)
Part B Pricing
Orthotics, prosthetics & vision services (indicator 38)
Type of Service
Lump-sum purchase of DME, prosthetics, orthotics
Effective Date
2003-01-01
2026 Maintenance
No change this year

References

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Reference L0458 with the canonical source and edition:

L0458 — Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment. ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/L0458

Canonical URL: https://icd10codingpro.com/hcpcs-codes/L0458

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Reviewed by Prajwal Shrestha, CPC, CRC
Certified Professional Coder (CPC) and Certified Risk Adjustment Coder (CRC) · AAPC Member ID 01997614 · About · Editorial policy · Content last reviewed: 2026-01-01

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