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TLSO Back Brace
Suggested HCPCS Code:
L0456/L0457
Single pulley system for easy adjustment
Easy to use, lightweight and durable
Adjustable posterior support, shoulder straps & thoracic support
4:1 Compression Ratio
Product Number
Size
12-0300
Universal Adult
Underlying Conditions:
Osteoarthritis
Spinal Stenosis
Intervertebral Disc Disorders
Sprain of Spine and/or Pelvis
Coverage Criteria:
(Patient must meet one of the following criteria)
Reduce pain by restricting mobility of trunk
Help heal injury to spine or related soft tissue
Help heal post-surgery to spine or related soft tissue
Supporting weak spinal muscles and/or deformed spine
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