Premium Wrist Brace
Suggested HCPCS Code: L3908
- Lycra lined splint for moisture wicking comfort
- Removable palmer stay for exceptional support
- Velcro closure for perfect fit
| Product Number | Side | Size | Wrist Circumference |
| 14-0900 | Right | X-Small | 4.5″-5.5″ |
| 14-0901 | Left | X-Small | 4.5″-5.5″ |
| 14-0902 | Right | Small | 5.5″-6.5″ |
| 14-0903 | Left | Small | 5.5″-6.5″ |
| 14-0904 | Right | Medium | 6.5″-7.5″ |
| 14-0905 | Left | Medium | 6.5″-7.5″ |
| 14-0906 | Right | Large | 7.5″-8.5″ |
| 14-0907 | Left | Large | 7.5″-8.5″ |
| 14-0908 | Right | X-Large | 8.5″+ |
| 14-0909 | Left | X-Large | 8.5″+ |
Underlying Conditions:
- Wrist Fracture
- Wrist Sprain
- Carpal Tunnel Syndrome
- Wrist Instability
- Osteoarthritis
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of 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.
