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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:
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.
Contact Us
Auth to Bill / Brace Request Form