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Documents

To be used for reference only...

INFORMATION:

HCPC billing-Custom Fabricated vs. Pre-Fabricated

ICD-10 for TENS and Conductive Garment

ICD-10 for Spinal Orthoses

ICD-10 for Knee Orthoses

 

FORMS:

Proof of Delivery Form

LH DME Back Brace Delivery Ticket

ASSIGNMENT OF BENEFITS

LH DME Patient Packet

LETTERS OF MEDICAL NECESSITY

TENS:

Medicare TENS

TENS Unit/Garment (E0730/E0731)

Conductive Garment

 

TRUNK:

Multipost Therapy Collar (L0180)

Cervical Traction

Theratrak (E0849)

LSO/TLSO

LSO/TLSO with Custom Fit Options

LSO (L0631)

LSO (L0637)

Scoliosis Brace (L1005)

 

 

LOWER EXTREMITIES:

Knee Brace

Knee Brace (L1812)

Knee Brace (L1830)

Knee Brace (L1832)

Knee Brace (L1833)

Knee Brace (L1843)

Knee Brace (L1845)

Knee Brace (L1851)

Knee Brace (L1852)

Knee (L2397/2795)

Ankle Brace (L1902)

Ankle Brace (L1971)

 

UPPER EXTREMITIES:

Elbow Brace (L3761)

WHFO (L3807)

WHFO (L3809)

 

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