HCPCS Level II L0486: TLSO, Triplanar Control, Custom Rigid Plastic

HCPCS Level II code L0486 describes a custom-fabricated two-piece rigid plastic TLSO (thoracolumbosacral orthosis) with triplanar control, multiple straps and closures, interface liner, posterior trim from the sacrococcygeal junction to just below the scapular spine and anterior trim from the symphysis pubis to the sternal notch, designed to restrict gross trunk motion in the sagittal, coronal, and transverse planes and including a carved plaster or CAD-CAM model; service type: custom-fabricated spinal orthosis fabrication; typical site of service: outpatient orthotics/prosthetics clinic or hospital orthotics lab.

Customize your policy alerts

Sign up for hcpcs L0486 policy alerts

Get alerted when payer policies referencing L0486 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Explore openpayer tools

View all tools

HCPCS Level II L0486: TLSO, Triplanar Control, Custom Rigid Plastic

Customize your policy alerts

Sign up for hcpcs L0486 policy alerts

Get alerted when payer policies referencing L0486 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with multilevel thoracolumbar instability after spinal fusion and progressive kyphotic deformity presents to an orthotics clinic. The treating spine surgeon requests a custom-fabricated, two-piece rigid trilateral TLSO to provide triplanar control and limit gross trunk motion in flexion/extension, lateral bending, and rotation while fusion consolidates. The orthotist performs a clinical evaluation, obtains a carved plaster or CAD-CAM model of the patient’s torso, fabricates the rigid plastic shells with interface liner, fits multiple straps and closures, and instructs the patient on donning, skin inspection, and wear schedule. Typical workflow: patient referral from surgeon or physiatrist → initial orthotic evaluation and measurements → model capture (plaster or CAD-CAM) → custom fabrication in lab → in-person fitting and adjustments → follow-up visits for strap tensioning and skin checks. Typical site of service: outpatient orthotics/prosthetics clinic, hospital-based orthotics service, or ambulatory surgery center when coordinated with spine procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97760`	Orthotic management and training; initial encounter for fitting and training with orthosis, one piece	Often billed for patient education, fitting, and training when the orthotist documents initial training on a custom TLSO.
`97763`	Orthotic/prosthetic management and training, subsequent encounter	Used for follow-up visits providing adjustments, continued training, and functional assessment after initial TLSO fitting.
`99070`	Supplies and materials (except spectacles) provided by the physician over and above those usually included with the office visit	May be reported for non-custom consumable materials used during fabrication or modification if payer allows separate billing.
`67900`	(Placeholder - Data not available in the input.)	Data not available in the input.
`L3908`	(Placeholder - Data not available in the input.)	Data not available in the input.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –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…
32	Modifier 32 (Mandated Services) indicates that a CPT-coded service was required by a third party—such as an insurer, school, state agency, or court. The AMA defines it as denoting services mandated…	- Use Modifier 32 when a service or procedure was explicitly mandated by a third party (for example an insurer requiring a second opinion, a school requiring a sports physical, a state agency or…
96	Modifier 96 is appended to CPT codes to indicate that a service or procedure was provided for habilitative purposes — i.e., to help a patient learn, maintain, or improve skills and functioning for…	- Use modifier -96 when a procedure or service that could be either habilitative or rehabilitative is provided specifically for habilitative purposes — i.e., to help a patient learn, maintain, or…
P4	Modifier P4 indicates the patient is ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life. It is assigned by the anesthesia provider and must be supported…	- When to apply: Use modifier P4 only on anesthesia CPT codes (00100–01999) to indicate ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life (examples:…
3P	The CPT Category II modifier -3P denotes a performance‑measure exclusion when a required quality action was not performed because of system‑level constraints. It is appended only to Category II…	- When to apply: Use CPT Category II modifier 3P only with Category II (‘‘F’’) codes when a specific quality measure’s specifications allow a system‑level exclusion — append 3P to indicate the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
2086S0129X	Vascular Surgery Physician	A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
207QP0002X	Physician Nutrition Specialist (Family Medicine)	A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…
2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina …
207VB0002X	Obesity Medicine (Obstetrics & Gynecology) Physician	A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…
261QP3300X	Pain Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

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

Showing 1–10 of 466

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`97760`	Orthotic management and training; initial encounter for fitting and training with orthosis, one piece	Often billed for patient education, fitting, and training when the orthotist documents initial training on a custom TLSO.
`97763`	Orthotic/prosthetic management and training, subsequent encounter	Used for follow-up visits providing adjustments, continued training, and functional assessment after initial TLSO fitting.
`99070`	Supplies and materials (except spectacles) provided by the physician over and above those usually included with the office visit	May be reported for non-custom consumable materials used during fabrication or modification if payer allows separate billing.
`67900`	(Placeholder - Data not available in the input.)	Data not available in the input.
`L3908`	(Placeholder - Data not available in the input.)	Data not available in the input.

Related Modifiers

5 rows

Modifier	Description	When to Use
22	Modifier –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…
32	Modifier 32 (Mandated Services) indicates that a CPT-coded service was required by a third party—such as an insurer, school, state agency, or court. The AMA defines it as denoting services mandated…	- Use Modifier 32 when a service or procedure was explicitly mandated by a third party (for example an insurer requiring a second opinion, a school requiring a sports physical, a state agency or…
96	Modifier 96 is appended to CPT codes to indicate that a service or procedure was provided for habilitative purposes — i.e., to help a patient learn, maintain, or improve skills and functioning for…	- Use modifier -96 when a procedure or service that could be either habilitative or rehabilitative is provided specifically for habilitative purposes — i.e., to help a patient learn, maintain, or…
P4	Modifier P4 indicates the patient is ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life. It is assigned by the anesthesia provider and must be supported…	- When to apply: Use modifier P4 only on anesthesia CPT codes (00100–01999) to indicate ASA Physical Status IV — a patient with severe systemic disease that is a constant threat to life (examples:…
3P	The CPT Category II modifier -3P denotes a performance‑measure exclusion when a required quality action was not performed because of system‑level constraints. It is appended only to Category II…	- When to apply: Use CPT Category II modifier 3P only with Category II (‘‘F’’) codes when a specific quality measure’s specifications allow a system‑level exclusion — append 3P to indicate the…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2084P0800X	Psychiatry Physician	A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
2086S0129X	Vascular Surgery Physician	A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
207QP0002X	Physician Nutrition Specialist (Family Medicine)	A physician who specializes in the diagnosis and treatment of primary nutritional diseases (e.g., undernutrition, overnutrition, and genetic or acquir…
2080P0008X	Pediatric Neurodevelopmental Disabilities Physician	A pediatrician who specializes in the treatment of individuals with developmental delays and learning disorders associated with cerebral palsy, spina …
207VB0002X	Obesity Medicine (Obstetrics & Gynecology) Physician	A physician who specializes in the treatment of obesity demonstrates competency in and a thorough understanding of the treatment of obesity and the ge…
261QP3300X	Pain Clinic/Center	Ambulatory Health Care Facilities · Clinic/Center

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

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

Showing 1–10 of 466

Frequently Asked Questions

References

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.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.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.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS Level II L0486: TLSO, Triplanar Control, Custom Rigid Plastic

Sign up for hcpcs L0486 policy alerts

OpenPayer

HCPCS Level II L0486: TLSO, Triplanar Control, Custom Rigid Plastic

Sign up for hcpcs L0486 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS Level II L0486: TLSO, Triplanar Control, Custom Rigid Plastic

Sign up for hcpcs L0486 policy alerts

HCPCS Level II L0486: TLSO, Triplanar Control, Custom Rigid Plastic

Sign up for hcpcs L0486 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What exactly does HCPCS code L0486 represent?

Which CPT codes are commonly billed with L0486 for fitting, training, or supplies?

What modifiers are shown as applicable for billing L0486 and when are they used?

In what clinical scenarios and care settings is a custom two-piece rigid TLSO (L0486) used and fabricated?

Which payers are referenced for coverage considerations of L0486, and does the page provide payer-specific policy details?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What exactly does HCPCS code L0486 represent?

Which CPT codes are commonly billed with L0486 for fitting, training, or supplies?

What modifiers are shown as applicable for billing L0486 and when are they used?

In what clinical scenarios and care settings is a custom two-piece rigid TLSO (L0486) used and fabricated?

Which payers are referenced for coverage considerations of L0486, and does the page provide payer-specific policy details?

References