Hip Knee Air Orthosis
Suggested HCPCS Code: L1652
- 4 air bladders (2 on each side) to redistribute skin pressure and gradually increase the hip’s range of motion
- Wide cuff straps provide comfort, increasing likelihood of patient compliance
- Spreader Bar Assembly with 3 choices of abductor-bar length provides greater hip abduction when needed
- Hand bulb air pump (included)
- Can be used in bed or in a wheelchair
| Product Number | Size | Thigh Circumference |
| 15-0100 | Small | 6″-12″ |
| 15-0102 | Medium | 11″-17″ |
| 15-0103 | Large | 16″-22″ |
| 15-0104 | X-Large | 21″-26″ |
Underlying Conditions:
- Osteoarthritis of the hip
- Hip contracture
- Hip adbuction
- Stress fracture of the hip
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of hip. (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.
