Healthcare Common Prodecure Coding System
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- Ethel Blankenship
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1 L0456 TLSO, FLEXIBLE, PROVIDES TRUNK SUPPORT, THORACIC REGION, RIGID POSTERIOR PANEL AND SOFT ANTERIOR APRON, EXTENDS FROM THE SACROCOCCYGEAL JUNCTION AND TERMINATES JUST INFERIOR TO THE SCAPULAR SPINE, RESTRICTS GROSS TRUNK MOTION IN THE SAGITTAL PLANE, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL DISKS, INCLUDES STRAPS AND CLOSURES, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE Healthcare Common Procedure Coding System The Healthcare Common Procedure Coding System (HCPCS) is a collection of codes that represent procedures, supplies,products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs. HCPCS codes primarily correspond to services, procedures, and equipment not covered by CPT codes. 2018
2 L0456 Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise HCPCS Code L0456 The Healthcare Common Prodecure Coding System (HCPCS) is a collection of codes that represent procedures, supplies, products and services which may be provided to Medicare beneficiaries and to individuals enrolled in private health insurance programs.the codes are divided into two levels, or groups, as described Below: Level I Codes and descriptors copyrighted by the American Medical Association's current procedural terminology, fourth edition (CPT-4). These are 5 position numeric codes representing physician and nonphysician services. **** NOTE: **** CPT-4 codes including both long and short descriptions shall be used in accordance with the CMS/AMA agreement. Any other use violates the AMA copyright. Level II Includes codes and descriptors copyrighted by the American Dental Association's current dental terminology, seventh edition (CDT-2011/12). These are 5 position alpha-numeric codes comprising the d series. All other level II codes and descriptors are approved and maintained jointly by the alphanumeric editorial panel (consisting of CMS, the Health Insurance Association of America, and the Blue Cross and Blue Shield Association). These are 5 position alpha- numeric codes representing primarily items and nonphysician services that are not represented in the level I codes
3 Code Short Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise Tlso flex trnk sj-ss pre cst Contains all text of procedure or modifier long descriptions. As of 2013, this field contains the consumer friendly descriptions for the AMA CPT codes. The AMA owns the copyright on the CPT codes and descriptions; CPT codes and descriptions are not public property and must always be used in compliance with copyright law. Short descriptive text of procedure or modifier code (28 characters or less). The AMA owns the copyright on the CPT codes and descriptions; CPT codes and descriptions are not public property and must always be used in compliance with copyright law. Pricing Indicator Code #1 38 Code used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes. Pricing Indicator Code #1 Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings). Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings of Pricing Indicator Code #1 Multiple Pricing Indicator Code A Code used to identify instances where a procedure could be priced under multiple methodologies. Multiple Pricing Indicator Code Not applicable as HCPCS priced under one methodology HCPCS Multiple Pricing Indicator Code Coverage Code C A code denoting Medicare coverage status. Coverage Code Berenson-Eggers Type Of Service Code Carrier judgment HCPCS Coverage Code D1F This field is valid beginning with 2003 data. The Berenson-Eggers Type of Service (BETOS) for the procedure code based on generally agreed upon clinically meaningful groupings of procedures and services
4 Berenson-Eggers Type Of Service Code Prosthetic/Orthotic devices HCPCS Berenson-Eggers Type Of Service Code Type Of Service Code #1 P The carrier assigned CMS type of service which describes the particular kind(s) of service represented by the procedure code. Type Of Service Code #1 Lump sum purchase of DME, prosthetics, orthotics of HCPCS Type Of Service Code #1 Anesthesia Base Unit Quantity 0 The base unit represents the level of intensity for anesthesia procedure services that reflects all activities except time. These activities include usual preoperative and post-operative visits, the administration of fluids and/or blood incident to anesthesia care, and monitering procedures. **** NOTE: **** The payment amount for anesthesia services is based on a calculation using base unit, time units, and the conversion factor. Code Added Date The year the HCPCS code was added to the Healthcare common procedure coding system. Action Effective Date Effective date of action to a procedure or modifier code Action Code N A code denoting the change made to a procedure or modifier code within the HCPCS system. Action Code No maintenance for this code HCPCS Action Code - 4 -
5 Contact Information for HCPCS HCPCS Address: The PDAC has a toll free helpline (877) HCPCS-related questions must be submitted online via the website - 5 -
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Healthcare Common Prodecure Coding System
L0468 TLSO, SAGITTAL-CORONAL CONTROL, RIGID POSTERIOR FRAME AND FLEXIBLE SOFT ANTERIOR APRON WITH STRAPS, CLOSURES AND PADDING, EXTENDS FROM SACROCOCCYGEAL JUNCTION OVER SCAPULAE, LATERAL STRENGTH PROVIDED
Healthcare Common Prodecure Coding System
L0627 LUMBAR ORTHOSIS, SAGITTAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR PANELS, POSTERIOR EXTENDS FROM L-1 TO BELOW L-5 VERTEBRA, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON THE INTERVERTEBRAL
Healthcare Common Prodecure Coding System
L0650 LUMBAR-SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR FRAME/PANEL(S), POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9 VERTEBRA, LATERAL STRENGTH PROVIDED BY RIGID
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Healthcare Common Prodecure Coding System
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Occupational Therapy I. Policy Occupational therapy is a form of rehabilitation therapy involving the treatment of neuromusculoskeletal function through the use of specific tasks or goal-directed activities
Physical Therapy MM /15/2003
Physical Therapy Policy Number: Original Effective Date: MM.09.005 07/15/2003 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 06/23/2017 Line(s) of Business Excluded: Federal Employee