Humeral Fracture Shoulder Brace
Suggested HCPCS Code: L3980
- Lightweight, durable, and cannot absorb moisture
- Trimmable polyethylene and lined with closed-cell foam
- Allows a range of motion at the shoulder and elbow
| Product Number | Size | Mid-Humeral Circ |
| 13-0800 | X-Small | 5″-7.5″ |
| 13-0801 | Small | 7.5″-9.5″ |
| 13-0802 | Medium | 9.5″-11.5″ |
| 13-0803 | Large | 11″-15″ |
| 13-0804 | X-Large | 13″-18″ |
Underlying Conditions:
- Fracture of the shaft of the Humerus
- Fracture of the surgical neck of Humerus
- Displaced fracture of the tuberosity of Humerus
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of upper body. (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.
