Cock-Up Wrist Splint with Roll
Suggested HCPCS Code: L3807/L3809
- Splint provides the wrist with cock-up position (~30° hyperextension)
- and free movement for the thumb and fingers.
- Finger extension roll can be added to provide stretching when desired
- High-temperature plastic base can be remolded as needed
- Thermal adaptive fabric helps to keep the patient’s hand cool and dry
| Product Number | Side | Size | Width of MCP |
| 14-1600 | Right | Small | Up to 3″ |
| 14-1601 | Left | Small | Up to 3″ |
| 14-1602 | Right | Medium | 3″-3.5″ |
| 14-1603 | Left | Medium | 3″-3.5″ |
| 14-1604 | Right | Large | 3.5″-3.75″ |
| 14-1605 | Left | Large | 3.5″-3.75″ |
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.
