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    v1.0.30
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l0113-cranial-cervical-orthosis-torticollis
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    HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

    HCPCS Level II code L0113 describes a prefabricated cranial cervical orthosis for torticollis, with or without a joint and with or without soft interface material, and includes fitting and adjustment; service type is durable medical equipment (prefabricated cranial cervical orthosis) typically provided in an outpatient orthopedic, rehabilitation, or durable medical equipment dispensing setting where fitting and adjustments are performed.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Patient Lifts, Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failure.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 6-month-old infant presents to a pediatric orthopedics clinic with a history of head preference and asymmetric neck posture noted since birth. On exam the infant demonstrates a persistent right-sided lateral head tilt with tightness of the right sternocleidomastoid muscle and limited cervical rotation consistent with congenital muscular torticollis. Conservative management including stretching and physical therapy has been initiated; the orthotist is consulted for a prefabricated cranial cervical orthosis to provide head and neck support between therapy sessions. The orthotist performs device selection, fitting, and in-clinic adjustments, educates the caregivers on wear schedule and skin checks, and documents objective fit measurements and patient response.

    A typical clinical workflow: referral to orthotics from pediatric orthopedics or physical therapy → orthotist evaluation and measurement → selection of a prefabricated cranial cervical orthosis (L0113) → trial fit and on-site adjustment → caregiver instruction and provision of written wear/safety guidance → scheduled follow-up visits for re-evaluation and further adjustments until resolution or progression to other interventions.

    Related CPT Codes

    • Common CPT codes performed alongside fitting and management of a cranial cervical orthosis include evaluation, measurement, and therapy services.
    CPT CodeDescriptionRelationship to This Procedure
    99203Office or other outpatient visit for the evaluation and management of a new patient, typically 30 minutesUsed for the initial physician or advanced practice provider evaluation that results in the orthotics referral and medical necessity documentation.
    97760Orthotic management and training, initial encounter, 15 minutesUsed by therapists to provide initial orthotic training, donning/doffing instruction, and caregiver education associated with the device.
    97763Orthotic/prosthetic management and training, initial encounter (each additional 15 minutes)Used for additional time spent on orthotic training when sessions exceed the base time.
    97001Physical therapy evaluation (historical code; replaced by 97161–97164)Historically used for initial PT evaluation; contemporary equivalents 97161–97164 may document functional status prompting orthotic referral.
    97110Therapeutic exercises to develop strength and endurance, each 15 minutesUsed by physical therapists providing adjunctive therapy (stretching and strengthening) while the orthosis is used.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207RH0000X
    207V00000X
    3336C0004X
    208200000X
    208000000X
    2080P0216X
    305S00000X
    111NT0100X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    G24.3Spasmodic torticollis
    G82.20Paraplegia, unspecified
    M43.4Other recurrent atlantoaxial dislocation
    M43.6Torticollis
    M48.02Spinal stenosis, cervical region
    M50.20Other cervical disc displacement, unspecified cervical region
    M50.21Other cervical disc displacement, high cervical region
    M50.30Other cervical disc degeneration, unspecified cervical region
    M50.31Other cervical disc degeneration, high cervical region
    M53.2X9Spinal instabilities, site unspecified

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Patient Liftsuniverahealthcare2026-11-16
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15
    Positive Airway Pressure Devices for Pulmonary Disorders Continued RentalCareSource Georgia2026-10-01
    Bone Growth StimulatorsProvidence Health Plan2026-10-01
    Durable Medical Equipment (DME) Medical Necessity and CoverageMass General Brigham Health Plan2026-10-01
    Speech Generating DevicesMass General Brigham Health Plan2026-10-01
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01

    Related Codes

    HCPCS-L0112-CRANIAL-CERVICAL-ORTHOSIS-CONGENITAL-TORTICOLLIS-CUSTOM

    HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

    HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

    HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

    HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

    HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

    HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

    HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

    HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

    HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

    HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

    HCPCS Level II L0170: Cervical Collar, Custom-Molded

    HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

    HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

    HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

    HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

    HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

    HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

    HCPCS-L0190-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-SUPPORT

    HCPCS L0190: Cervical Multiple Post Collar with Occipital/Mandibular Supports

    Showing 1–10 of 466

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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