Goniometer Locking Elbow Hand Combo Orthosis
Suggested HCPCS Code: L3760 and L3807/L3809
- Length and cuffs easily adjust for custom fit
- Adjust flexion/extension of elbow without removing stays
- Brace can be set for pronation or supination
- Washable, removable terry cloth cover
| Product Number | Size | Bicep Circ. |
| 13-0200 | Adult Regular | 11″-15″ |
| 13-0201 | Adult Small | 9″-12″ |
Underlying Conditions:
- Elbow Contracture
- Rheumatoid Arthritis
- Hemarthrosis of Elbow
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of elbow/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.
