in. (VCF). on how severe your injury is, you may experience Quick minor repairs to DME products. Indeed, the curvature in very aggressive scoliosis can continue to progress despite bracing. WebA custom-fabricated back brace (individually constructed to fit a specific member from component materials) is considered medically necessary if there is a failure, contraindication, or intolerance to a custom-fitted back brace. If you have a problem with your back that requires it to be kept in a neutral position while limiting excessive spinal motion, then a TLSO may be an option for you. (see Anatomy of the WebRehab Store is your companion on your road to recovery. in. or less, without adhesive border, each dressing, Hydrogel dressing, wound cover, sterile, pad size more than 16 sq. To understand spinal fractures, Cushion for use on nasal mask interface, replacement only, each, Pillow for use on nasal cannula type interface, replacement only, pair, Nasal interface (mask or cannula type) used with positive airway pressure devise, with or without head strap, Headgear used with positive airway pressure device, Chinstrap used with positive airway pressure device, Tubing used with positive airway pressure device, Filter, disposable, used with positive airway pressure device, Filter, non-disposable, used with positive airway pressure device, Oral interface used with positive airway pressure device, each, Exhalation port with or without swivel used with accessories for positive airway devices, replacement only, Alert or alarm device, not otherwise classified. Skin sealants, protectants, moisturizers, ointment, Tape, non-waterproof, per 18 square inches, Surgical dressing holder, non-reusable, each, Shoulder sling or vest design, abduction restrainer, with or without swathe control, prefabricated, includes fitting and adjustment. Syringe with needle, sterile, 5 cc up to 20 cc, each. Cincinnati, Ohio 45209, Appointments: 513-221-1100 The first doctor to see you in the ER Indicate medication administered, route of administration, dosage, frequency, and length of necessity on each prior authorization request. I ordered a TLSO brace, but shipping was going to take too long, so I ordered this to try in the interim. Spinal instability is the excessive motion We recommend that you do not solely rely on the information presented and that you always read labels, warnings, and directions before using or consuming a product. The jerking motion strains Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 4 foot panel, Ultraviolet light therapy system panel, includes bulbs/lamps, timer and eye protection, 6 foot panel, Ultraviolet multidirectional light therapy system in 6 foot cabinet, includes bulbs/lamps, timer and eye protection, Moisture exchanger, disposable, for use with invasive mechanical ventilation, Water chamber for humidifier, used with positive airway pressure device, replacement, each, IPPB machine(s), all types, with built in nebulization, manual or automatic valves, internal or external power source (Manual valves external power source includes cylinder regulator built-in nebulization), Humidifier, durable, for extensive supplemental humidification during IPPB treatment or oxygen delivery (e.g., Cascade), Humidifier, durable, glass or autoclavable plastic bottle type, for use with regulator or flowmeter, Humidifier, durable for supplemental humidification during IPPB treatment or oxygen delivery (e.g., Cascade Jr.), Humidifier, non-heated, used with positive airway pressure device, Humidifier, heated, used with positive airway pressure device. Use for cleaning solutions for respiratory equipment. Then, bring the front pad around to your chest, and lightly fasten the straps with the hook-and-loop fasteners. pneumatic, gel), prefabricated, off-the- shelf, Walking boot, pneumatic and/or vacuum, with or without joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf. Depending on the type of fracture and is put on a bone than it can stand, it will Size Large, Back Brace and Posture Corrector for Women and Men, Back Straightener Posture Corrector, Scoliosis and Hunchback Correction, Back Pain, Spine Corrector, Support, Adjustable Posture Trainer, Medium (Waist 34-41 Inch), VANRORA Posture Corrector for Women and Men, Back Brace Fully Adjustable & Comfy, Support Straightener for Spine, Back, Neck, Clavicle and Shoulder, Improves Posture and Pain Relief S/M, Posture Corrector for Women and Men, Upper Back Brace Straightener Posture Corrector for Clavicle Chest Support, ORTONYX Comfort Posture Corrector Clavicle and Shoulder Support Back Brace, Fully Adjustable for Men and Women/656A-Medium, Learn more how customers reviews work on Amazon. Use for hand held shower, and other miscellaneous bath equipment. Resuscitation bag (For use by patient on artificial respiration during power failure or other catastrophic event), Electrical stimulator supplies, 2 lead, per month, (e.g., TENS, NMES). Some TLSO braces have soft fabric on one side, offering comfort between your body and the straps that hold the brace in place. Submit paper claim with manufactures invoice attached. Do not provide more than 3 per DOS. Manual wheelchair accessory, hand rim with projections, any type, replacement only, each, Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each, Wheelchair accessory, seat upholstery, replacement only, each, Wheelchair accessory, back upholstery replacement only, each, Wheelchair accessory, elevating leg rest, complete assembly, each, Wheelchair accessory, calf rest/pad, replacement only, each, Modification to pediatric size wheelchair, width adjustment package (not to be dispensed with initial chair). Rental is per day: Bill with RR and a date span. In vertebroplasty, WebTLSO, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf L0452 Vascular graft material, synthetic, implant, Belt, strap, sleeve, garment, or covering, any type, Surgical stocking, above knee length, each, Surgical stocking, below knee length, each, Gradient compression stocking, below knee, 18-30 mm hg, each, Gradient compression stocking, below knee, 30-40 mm hg, each, Gradient compression stocking, below knee, 40-50 mm hg, each, Gradient compression stocking, thigh length, 18-30 mm hg, each, Gradient compression stocking, thigh length, 30-40 mm hg, each, Gradient compression stocking, thigh length, 40-50 mm hg, each, Gradient compression stocking, full length/chap style, 18-30 mm hg, each, Gradient compression stocking, full length/chap style, 30-40 mm hg, each, Gradient compression stocking, full length/chap style, 40-50 mm hg, each, Gradient compression stocking, waist length, 18-30 mm hg, each, Gradient compression stocking, waist length, 30-40 mm hg, each, Gradient compression stocking, waist length 40-50 mm hg, each, Gradient compression stocking, garter belt, Gradient compression wrap, non-elastic, below knee, 30-50 mm hg, each, Gradient compression stocking/sleeve, not otherwise specified, Hot water bottle, ice cap or collar, heat and/or cold wrap, any type, Heat lamp, without stand (table model), includes bulb or infrared element, each. PARs for this item are limited to 6-month spans at a time. The length of time you wear your thoracic lumbar sacral orthosis depends on your condition and your physicians instructions. Must be provided if equipment is rented. a rigid collar (Miami J) for cervical fractures, Some thoracic lumbar sacral orthoses are adjustable once the brace is worn. When a tumor is suspected as the underlying cause, or the fracture was caused by severe trauma, CT or MRI scans may be performed. but less than or equal to 48 sq. : in., without adhesive border, each dressing, Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. Then the muscles would be able to support the spine, preventing further collapse. in. Postural Extension Back Straightener Brace - Rigid Posture Corrector Vest for Kyphosis Hunch Relief, Mild Scoliosis Support, and Hunchback or Lordosis Spine Treatment. Reviewed in the United States on October 22, 2019, I like the tough design and the strength and support it provides my back, Reviewed in the United States on December 23, 2019, Reviewed in the United States on September 17, 2021. A back brace is a device designed to limit the motion of the spine in cases of bone fracture or in post-operative spinal fusiona, as well as a preventative measure against some progressive conditions or to correct patient posture. The brace corrects hip misalignments through padding. Wheelchair component or accessory, not otherwise specified. an X-ray, nerves and discs are clearly visible. TLSO refers to the region of the back these braces support, including the thoracic, lumbar and sacrum part of the spine. STEEL SPRINGS: Eight supportive steel springs conform to the lower back for firm support. WebThe spine is kept in a neck or back brace until appropriate diagnostic tests are completed. To calculate the overall star rating and percentage breakdown by star, we dont use a simple average. in., each dressing, Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. 2 footplates, except for elevating leg rest, Manual wheelchair accessory, anti- tipping device, each, Manual wheelchair accessory, anti- rollback device, each, Wheelchair accessory, positioning belt/safety belt/pelvic strap, each, Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, joystick control, Manual wheelchair accessory, power add-on to convert manual wheelchair to motorized wheelchair, tiller control, Wheelchair accessory, seat lift mechanism, Manual wheelchair accessory, lever- activated, wheel drive, pair, Manual wheelchair accessory, solid seat insert, Residual limb support system for wheelchair, any type, Wheelchair accessory, manual swing away, retractable or removable mounting hardware for joystick, other control interface or positioning accessory, Wheelchair accessory, ventilator tray, fixed, Wheelchair accessory, ventilator tray, gimbaled, Wheelchair accessory, manual semi- reclining back, (recline greater than 15 degrees but less than 80 degrees, Manual wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each, Special wheelchair seat height from floor, Special wheelchair seat depth, by upholstery, Special wheelchair seat depth and/or width, by construction, Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches, Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches, Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches, Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches, Wheelchair accessory, crutch and cane holder, each, Wheelchair accessory, cylinder tank carrier, each, Power wheelchair accessory, nonstandard seat frame width, 20-30 inches, Power wheelchair accessory, nonstandard seat frame width 24-27 inches, Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches, Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches, General use wheelchair seat cushion, width less than 22 inches, any depth. Required: F2F may be required. bones. Use A7035 for headgear purchase. Unable to add item to List. in., without adhesive border, each dressing, Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. Power wheelchair accessory, 12 to 24 AMP hour sealed lead acid battery, each (e.g., gel cell, absorbed glassmat), Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each, Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each, Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware, Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware, Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable, Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable Rancho type, Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, reclining, Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, friction arm support (friction dampening to proximal and distal joints), Wheelchair accessory, shoulder elbow, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support, Wheelchair accessory, addition to mobile arm support, elevating proximal arm, Wheelchair accessory, addition to mobile arm support, offset or lateral rocker arm with elastic balance control, Wheelchair accessory, addition to mobile arm support, supinator, Positioning seat for persons with special orthopedic needs. Between the dates of 7-1-2020 and 6-30-2021 this code was allowed for continuous rental when used as a ventilator. This back brace fit the bill and at a reasonable price, too. Instrumentation & Fusion are surgical procedures to treat unstable fractures. Depending on your First, wearing a brace may make your core muscles weak and tight, leading to difficulty with movement. in. Spinal fractures and dislocations Bracing is the primary treatment for AIS in curves that are considered to be moderate in their severity and are likely due to progress (determined by curve pattern/type and the patient's structural maturity). of a vertebra can cause bone fragments to pinch Device must be under full manufacturer warranty at the time of delivery to the member. *See CPAP/BiPAP under the Benefits section for additional information. 'to straighten, to align') is a medical specialty that focuses on the design and application of orthoses, or braces.An orthosis is "an externally applied device used to influence the structural and functional characteristics of the neuromuscular and skeletal system". Aspen Horizon 456 TLSO One Size Adjustable Back Brace 993740 Spine Fracture. in. WebA back brace is a device designed to limit the motion of the spine in cases of bone fracture or in post-operative spinal fusiona, as well as a preventative measure against some progressive conditions or to correct patient posture.. Common back braces include: Rigid (hard) braces : These braces are form-fitting plastic molds (historically leather) and rigid WebI ordered this back support for pain relief from a vertebral compression fracture. in., without adhesive border, each dressing, Gauze, non-impregnated, sterile, pad size 16 sq. Other body injuries (e.g., to It's very painful for me to both stand and walk, and often to even sit, so I had to have something. in an auto accident). Aspen Horizon 456 TLSO One Size Adjustable Back Brace 993740 Spine Fracture. Per CMS guidelines, real time gait assessment and other tasks shall not be billed under L5999. WebAligner PHX Humeral Fracture Brace; Aluminum Push Button Crutches; Ambulite Arm Sling; EPO Post-Op Knee Brace; Essential Elbow Sleeve with Compression Strap; Essential Shoulder Immobilizer; VersaFit Wrist Brace with Thumb Spica; Vista 464 TLSO; Vista 631 LSO LoPro; Vista 637 LSO; Vista 639; The compression the back support applies can be easily adjusted and applied thanks to Cybertechs patented mechanical advantage pulley system. Products with electrical plugs are designed for use in the US. The dual pulleys enhance compliance as well as conformity to the development of the hips. ), cement, powder or paste, any composition, per ounce, Ostomy skin barrier, liquid (spray, brush, etc. in., without adhesive border, each dressing, Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. A TLSO is a brace that limits movement in your spine from the thoracic area (mid back) to your sacrum (low back). If you have a spinal compression fracture, either due to trauma or osteoporosis, your physician may have you wear a TLSO to minimize spinal motion while your fracture is healing. or less, each dressing, Transparent film, sterile, more than 16 sq. the muscles and ligaments of the neck and Posture Corrector for Body Correction & Neck Pain, Braces & Supports to Help you Get Back to Life. Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell), Home ventilator, multi-function respiratory device, also performs any or all of the additional functions of oxygen concentration, drug nebulization, aspiration, and cough stimulation, includes all accessories, components and supplies for all functions, Respiratory assist device, bi-level pressure capability, without back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device), Rental includes all related supplies, including but not limited to the, Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device), Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with invasive interface, e.g., tracheostomy tube (intermittent assist device with continuous positive airway pressure device), Percussor, electric or pneumatic, home model, Intrapulmonary percussive ventilation system and related accessories, Cough stimulating device, alternating positive and negative airway pressure. Easy to put on, take off, or adjust the brace. Continuous positive airway pressure (CPAP) device, Canister, disposable, used with suction pump, Canister, non-disposable, used with suction pump, Administration set, with small volume nonfiltered pneumatic nebulizer, disposable, Small volume non-filtered pneumatic nebulizer, disposable, Administration set, with small volume nonfiltered pneumatic nebulizer, non- disposable, Administration set, with small volume filtered pneumatic nebulizer, Large volume nebulizer, disposable, unfilled, used with aerosol compressor, Large volume nebulizer, disposable, pre- filled, used with aerosol compressor, Reservoir bottle, non-disposable, used with large volume ultrasonic nebulizer, Corrugated tubing, disposable, used with large volume nebulizer, 100 feet, Water collection device, used with large volume nebulizer, Filter, disposable, used with aerosol compressor or ultrasonic generator, Filter, non-disposable, used with aerosol compressor or ultrasonic generator, Dome and mouthpiece, used with small volume ultrasonic nebulizer, Nebulizer, durable glass, or autoclavable plastic, bottle type, not used with oxygen, Water, distilled, used with large volume nebulizer, 1000 ml, Compressor, air power source for equipment which is not self-contained or cylinder driven, Aerosol compressor, adjustable pressure, light duty for intermittent use, Ultrasonic electronic aerosol generator with small volume nebulizer, Nebulizer, durable glass or autoclavable plastic bottle type for use with regulator or flowmeter, each, Respiratory suction pump, home model, portable or stationary, electric, Controlled dose inhalation drug delivery system, Tracheostomy filter, any type, any size, each, Tracheal suction catheter, closed system, each, Oxygen probe for use with oximeter device, replacement, Battery, heavy duty, replacement for patient owned ventilator, each, Battery cables, replacement for patient owned ventilator, each, Battery charger, replacement for patient owned ventilator, each, Peak expiratory flow rate meter, hand held. Use modifier U1 for fingertip pulse oximeters and U2 for tabletop pulse oximeters effective January 1, 2023. After viewing product detail pages, look here to find an easy way to navigate back to pages you are interested in. with a dye (contrast agent) injected into your Effective 7-1-2021 this code will no longer be allowed for continuous rental. For rental, must submit manufacturer's invoice with PAR. Must be provided by supplier for rented equipment. TLSO refers to the region of the back these braces support, including the thoracic, lumbar and sacrum part of the spine. The dual pulleys enhance compliance as well as conformity to the development of the hips. If the TLSO is too tight, you may find that lung function is impaired; wearing your brace properly and as prescribed is important. Rigid TLSO for 2 hours/day with a 75% decrease in the need for surgery. Limited coverage policy ended 6/7/2022. fiber), In-line cartridge containing digestive enzyme(s) for enteral feeding, each, Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories=1 unit, Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit. Oximeter device for measuring blood oxygen levels non-invasively, Pacemaker monitor, self-contained (checks battery depletion, includes audible & visual check systems), each, Pacemaker monitor, self-contained, checks battery depletion & other pacemaker components, includes digital/visual check systems, each, Automatic external defibrillator, with integrated electrocardiogram analysis, garment type, Replacement battery for automated external defibrillator, garment type only, each, Replacement garment for use with automated external defibrillator, each, Replacement electrodes for use with automated external defibrillator, garment type only, each, Enuresis alarm, using auditory buzzer and/or vibration device, Home uterine monitor with or without associated nursing services. in. It utilizes large, sweeping pads to push the body against its curve and into blown out spaces. fractures may require surgery to realign the Posture corrector realign body to its original position by straightening from ankle to knee, pelvis, and shoulders to ear. WebThe DonJoy Back Brace II TLSO accommodates the appropriate motion restriction throughout the healing process. The Milwaukee brace was a very common brace towards the earlier part of the twentieth century in the United States. to view the bony vertebrae in your spine and It is situated in between the thoracic and the sacral part of the spine and is characterised by lordosis. Ankle Footorthosis AFO then you have two choices. Stand upright, and tighten each strap so the TLSO fits snugly but comfortably. Halo Vest vs. Spinal Fusion: Uses, Benefits, Side Effects, and More. It is important to note that in-brace correction has been found to be directly related with treatment success,[5] suggesting in-brace correction should be maximized; thus individualized custom braces which maximize in-brace correction show better results. Operative. (TLSO) is the current brace of choice for these types of injuries. Tracheostomy supply, not otherwise classified. Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf, Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated, CTLSO, anterior-posterior-lateral control, molded to patient model (Minerva type), CTLSO, anterior-posterior-lateral control, molded to patient model, with interface material (Minerva type), Halo procedure, cervical halo incorporated into jacket vest, Halo procedure, cervical halo incorporated into plaster body jacket, Halo procedure, cervical halo incorporated into Milwaukee type orthosis, Addition to halo procedure, replacement liner/interface material, Stocking supporter grips, prefabricated, off-the-shelf, set of four (4), Protective body sock, prefabricated, off- the-shelf, each, CTLSO (Milwaukee), inclusive of furnishing initial orthosis, including model, Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment, Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment, Addition to CTLSO or scoliosis orthosis, axilla sling, Addition to CTLSO or scoliosis orthosis, kyphosis pad, Addition to CTLSO or scoliosis orthosis, kyphosis pad, floating, Addition to CTLSO or scoliosis orthosis, lumbar bolster pad, Addition to CTLSO or scoliosis orthosis, lumbar or lumbar rib pad, Addition to CTLSO or scoliosis orthosis, sternal pad, Additions to CTLSO or scoliosis orthosis, thoracic pad, Addition to CTLSO or scoliosis orthosis, trapezius sling, Addition to CTLSO or scoliosis orthosis, outrigger, Addition to CTLSO or scoliosis orthosis, outrigger, bilateral with vertical extensions, Addition to CTLSO or scoliosis orthosis, lumbar sling, Addition to CTLSO or scoliosis orthosis, ring flange, plastic or leather, Addition to CTLSO or scoliosis orthosis, ring flange, plastic or leather, molded to patient model, Addition to CTLSO or scoliosis orthosis, cover for upright, each, TLSO, inclusive of furnishing initial orthosis only, Addition to TLSO, (low profile), lateral thoracic extension, Addition to TLSO, (low profile), anterior thoracic extension, Addition to TLSO, (low profile), Milwaukee type superstructure, Addition to TLSO, (low profile), lumbar derotation pad, Addition to TLSO, (low profile), anterior ASIS pad, Addition to TLSO, (low profile), anterior thoracic derotation pad, Addition to TLSO, (low profile), abdominal pad, Addition to TLSO, (low profile), rib gusset (elastic), each, Addition to TLSO, (low profile), lateral trochanteric pad, Other scoliosis procedure, body jacket molded to patient model, Other scoliosis procedure, postoperative body jacket, HO, abduction control of hip joints, flexible, Frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, HO, abduction control of hip joints, flexible, (Frejka cover only), prefabricated, includes fitting and adjustment, HO abduction control of hip joints, flexible, (Pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, HO abduction control of hip joints, semi- flexible (Von Rosen type), custom fabricated, HO, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated, HO, abduction control of hip joints, static, adjustable (Ilfled type), prefabricated, includes fitting and adjustment, Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type, HO abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment, HO abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (Rancho hip action type), custom fabricated, HO abduction control of hip joint, postoperative hip abduction type, custom fabricated, HO abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment, Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment, Legg Perthes orthosis, (Toronto type), custom fabricated, Legg Perthes orthosis, (Newington type), custom fabricated, Legg Perthes orthosis, trilateral, (Tachdijan type), custom fabricated, Legg Perthes orthosis, (Scottish Rite type), custom fabricated, Legg Perthes orthosis, (Patten bottom type), custom fabricated, Dynamic adjustable knee extension/ flexion device, includes soft interface material, Static progressive stretch knee device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories, Dynamic knee, extension/flexion device with active resistance control, KO, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, Knee orthosis, elastic with joints, prefabricated, off-the-shelf, Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment, KO, immobilizer, canvas longitudinal, prefabricated, off-the-shelf, Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment, Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf, KO, without knee joint, rigid, custom fabricated, KO, rigid, without joint(s), includes soft interface material, prefabricated, off-the- shelf, KO, derotation, medial-lateral, anterior cruciate ligament, custom fabricated, Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated, Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, custom fabricated, KO, double upright with adjustable joint, with inflatable air chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual w/ expertise, Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off- the-shelf, KO, Swedish type, prefabricated off-the- shelf, Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf.
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