Exoform Knee Immobilizer

Suggested HCPCS Code: L1830

  • Easy to fit with “slide to size” straps
  • Dual cuffs and popliteal supports for exact immobilization
  • Sleeve under brace for patient warmth
  • Durable, comfortable and latex free
Product Number Size Style
11-1300 Universal Full Foam
11-1301 Universal Cool Foam
Underlying Conditions:
  • Knee Derangement
  • ACL Tear
  • Congenital Deformity of Knee Joint
  • Chondromalacia of Patella
  • Old Bucket Handle of Medial Meniscus
  • Pathologic Fracture of Femur/Tibia/Fibula
  • Disruption of MCL
  • Rheumatoid Arthritis
  • Osteoarthritis
Coverage Criteria:
  • Recent knee injury or recent surgical procedure on knee
For Product Instructions click HERE.

Our Process is as follows: