ACL KNEE BRACE

ACL Knee Brace

Suggested HCPCS Code: L1845/L1852

  • Sleek, low profile design
  • Durable, lightweight aluminum construction
  • Flexion (45°, 60°, 75°, 90°) and extension (0°, 10°, 20°, 30°, 40°) stops
Product NumberSideSizeCirc 6″ Above Knee Center
11-1200RightSmall15.5″-18.5″
11-1201LeftSmall15.5″-18.5″
11-1202RightMedium18.5″-21″
11-1203LeftMedium18.5″-21″
11-1204RightLarge21″-23.5″
11-1205LeftLarge21″-23.5″
11-1206RightX-Large23.5″-26.5″
11-1207LeftX-Large23.5″-26.5″

Underlying Conditions:

  • ACL Tear
  • Congenital Deformity of Knee Joint
  • Chondromalacia of Patella
  • Old Bucket Handle of Medial Meniscus
  • Pathologic Fracture of Femur/Tibia/Fibula
  • Rheumatoid Arthritis
  • Osteoarthritis

Coverage Criteria:

Patient must meet one of the following criteria)

  • Recent knee injury or Recent surgical procedure on knee
  • Patient is ambulatory and has knee instability due to diagnosisstabilization

For Product Instructions click HERE.

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