L0484 Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated
Short descriptor: Tlso rigid plastic cust fab
Look up L0484 alongside ICD-10-CM diagnoses, the HCPCS Table of Drugs, and the AI coding assistant.
L0484 is the HCPCS Level II code for Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated (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
Cite This Page
Reference L0484 with the canonical source and edition:
L0484 — Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated. ICD-10 Coding Pro (HCPCS Level II 2026). https://icd10codingpro.com/hcpcs-codes/L0484
Canonical URL: https://icd10codingpro.com/hcpcs-codes/L0484