Adjustable Wrist and Hand Contracture Splint
Suggested HCPCS Code: L3915/L3916
- Bilateral
- Adjustable locking hinge to increase wrist extension
- Lightweight, breathable, and comfortable
- Moldable aluminum core for a custom fit
- Fits comfortable over and under clothes
| Product Number | Size | Wrist Circumference |
| 14-0800 | Small | Up to 7″ |
| 14-0801 | Medium | 7.5″-8.5″ |
| 14-0802 | Large | 9″-10″ |
| 14-0803 | X-Large | 10.5″ |
Underlying Conditions:
- Rheumatoid Arthritis
- Wrist/Hand Contracture
- Carpal Tunnel Syndrome
- Osteoarthritis
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of hand . (Not preventative.)
Our Process is as follows:
- 1. Choose a brace, send a brace request form and a facesheet to our office.
- 2. PME will verify insurance coverage, prepare a script and send it to the requester for a DR signature.
- 3. Facility sends back signed script
- 4. PME ships brace to the facility.
