Thumb Spica Wrist Brace
Suggested HCPCS Code: L3807/L3809
- Memory foam laminate for ultimate patient comfort
- Malleable aluminum stays for customized fit
- Quick lace system
- Contoured, adjustable thumb-web strap
- Integrated cotton knit panel for ease of application
| Product Number | Side | Size | Wrist Circumference |
| 14-1000 | Right | X-Small | 5″-5.75″ |
| 14-1001 | Left | X-Small | 5″-5.75″ |
| 14-1002 | Right | Small | 5.75″-6.25″ |
| 14-1003 | Left | Small | 5.75″-6.25″ |
| 14-1004 | Right | Medium | 6.25″-6.75 |
| 14-1005 | Left | Medium | 6.25″-6.75 |
| 14-1006 | Right | Large | 6.75″-7.75″ |
| 14-1007 | Left | Large | 6.75″-7.75 |
| 14-1008 | Right | X-Large | 7.75″+ |
| 14-1009 | Left | X-Large | 7.75″+ |
Underlying Conditions:
- Wrist Fracture
- Wrist Sprain
- Carpal Tunnel Syndrome
- Wrist/Hand Contracture
- Osteoarthritis
- Rheumatoid Arthritis
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.
