WebFeb 15, 2004 · with a prefabricated brace as a result of any of the following: abnormal limb contour, (disproportionate size and shape) knee deformity, or large size, all of which would preclude the use of an off-the-shelf ... L1850 Knee orthosis, swedish type, prefabricated, off-the-shelf L1851 Knee orthosis (KO), single upright, thigh and calf, with ... WebJan 10, 2015 · There is a need to control the knee, ankle or foot in more than one plane; or, The beneficiary has a documented neurological, circulatory, or orthopedic status that requires custom fabricating over a model to prevent tissue injury; or, The beneficiary has a healing fracture which lacks normal anatomical integrity or anthropometric proportions.
Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot ... - Aetna
WebOct 26, 2024 · ICD-10-CM Codes that Support Medical Necessity - Group 5 Knee Orthoses Policy Article . Custom Fabricated Knee Orthoses (L1834, L1840, L1844, L1846, L1860) Custom fabricated orthoses are covered when there is a documented physical characteristic which requires the use of a custom fabricated orthosis instead of a prefabricated … WebROM positioning of the KMO™ knee joint can be pre-set prior to the actual fitting or while it's on the patient's lower extremity. PDAC APPROVED L-1831 KMO™ Orthosis is protected under U.S. Patent No 7,122,016 REQUEST A QUOTE KMO™ Knee Orthosis- Adjustments KMO™ Knee Orthosis Benefits and Uses domino\u0027s pizza south jordan
Orthotic Devices and Shoes - Cigna
WebAFO, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment: L2114: AFO, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment [for ankle sprains only] ... A total of 21 subjects were fitted unilaterally with the Dynamic Knee Brace System (DKBS), a non ... WebNov 14, 2016 · Code L1852 describes a prefabricated, OTS knee orthoses with: Double uprights, Condylar pads, Adjustable flexion and extension joint, Both medial-lateral and … WebKnee Orthosis Prefabricated Knee Orthoses L1810 L1812 L1820 A knee orthosis, elastic with joints, or knee orthosis with condylar pads and joints, with or without patellar control may be considered medically necessary for ambulatory individuals who have weakness or deformity of the knee and require stabilization. domino\u0027s pizza smyrna ga