HCPCS Range Hip Orthotics

• 1 Hip orthosis, 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 with expertise ( L1600 )

• 2 Hip orthosis, abduction control of hip joints, flexible, (Frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1610 )

• 3 Hip orthosis, 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 with expertise ( L1620 )

• 4 Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom-fabricated ( L1630 )

• 5 Hip orthosis (HO), abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom-fabricated ( L1640 )

• 6 Hip orthosis (HO), abduction control of hip joints, static, adjustable, (Ilfled type), prefabricated, includes fitting and adjustment ( L1650 )

• 7 Hip orthosis (HO), bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type ( L1652 )

• 8 Hip orthosis (HO), abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment ( L1660 )

• 9 Hip orthosis (HO), abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (Rancho hip action type), custom fabricated ( L1680 )

• 10 Hip orthosis (HO), abduction control of hip joint, postoperative hip abduction type, custom fabricated ( L1685 )

• 11 Hip orthosis (HO), abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment ( L1686 )

• 12 Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment ( L1690 )

• 13 Hip orthosis, bilateral hip joints and thigh cuffs, adjustable flexion, extension, abduction control of hip joint, postoperative hip abduction type, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1681 )