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Shoulder Immobilizer with Waist Strap
Suggested HCPCS Code:
L3670
Soft cotton/poly blend for increased comfort
Removable foam waist strap
D-ring on strap for easy adjustmant
Fits right or left arm
Product Number
Size
Pouch Length
13-0600
Small
13″
13-0601
Medium
15″
13-0602
Large
17″
13-0603
X-Large
19.5″
Underlying Conditions:
Fracture of Shaft of Clavicle
Fracture of Sternal End of Clavicle
Sprain of the Shoulder or Elbow
Stiffness of Shoulder not Elsewhere Classified
Elbow Fracture
Ulna Fracture
Coverage Criteria:
Item is for treatment of illness or injury or to improve function of upper body. (Not preventative.)
For Product Instructions click
HERE
.
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.
Contact Us
Auth to Bill / Brace Request Form