ROM Padded Air Elbow Brace
Suggested HCPCS Code: L3760/L3761
- Air technology uses an air bladder at the inside of the elbow, positioned parallel to the arm to redistribute skin pressure
- Bilateral hinged uprights work with the air bladders to continue to move the joint toward normal alignment
- Hinges can be removed for the most severe flexion and added as the range improves
| Product Number | Side | Bicep Circ. | Forarm Circ. |
| 13-0400 | Right | 8″-15″ | 7″-12″ |
| 13-0401 | Left | 8″-15″ | 7″-12″ |
Underlying Conditions:
- Elbow Contracture
- Rheumatoid Arthritis
- Hemarthrosis of Elbow
- Felty’s Syndrome of Elbow
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of elbow. (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.
