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    v1.0.31
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l0720-prefab-ct-ls-orthosis-customized-fit
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    HCPCS Level II L0720: Prefabricated Cervical-Thoracic-Lumbar-Sacral Orthosis, Customized Fit

    HCPCS Level II code L0720 describes a prefabricated cervical-thoracic-lumbar-sacral orthosis (CTLSO) with anterior-posterior-lateral control that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient; this represents an orthotic device service typically provided in an outpatient durable medical equipment (DME)/orthotics clinic or hospital outpatient setting where an orthotist or trained clinician performs patient-specific modifications for spinal support and stabilization.

    For related coverage guidance, see recent payer policy updates: Patient-Controlled End Range of Motion Stretching Devices, Sleep Position Trainer, Hospital Beds Corporate Medical Policy.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 56-year-old patient with multilevel degenerative disc disease and thoracolumbar kyphosis presents to an orthotics clinic after spine surgeon consultation. The surgeon prescribes a prefabricated cervical-thoracic-lumbar-sacral orthosis to provide anterior-posterior-lateral control of the spine for stabilization during the postoperative healing phase. The orthotist performs a focused evaluation including measurements, skin inspection, and functional assessment. The prefabricated CTLSO is trimmed, bent, and molded by the orthotist to the patient’s anatomy, and straps and pads are adjusted for pressure redistribution.

    The workflow includes: initial prescription from the treating physician, orthotist evaluation and fitting, patient education on application, donning/doffing and skin care, delivery documentation including itemized device description and level of customization, and follow-up visits for fit checks and adjustments. Typical sites of service are outpatient orthotics/prosthetics clinics, hospital-based orthotics departments, surgical clinics, and home health visits when mobility is limited.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97161Physical therapy evaluation, low complexityInitial PT evaluation commonly performed before or after CTLSO fitting to assess function
    97760Orthotic management and training, initial encounterDirectly related: training patient in use, donning/doffing, and care of the CTLSO
    99070Supplies and materials (e.g., additional padding, strapping)Billed when non-covered supplies or extra materials are provided with the orthosis
    99213Office or other outpatient visit for the evaluation and management of an established patientTypical visit code for physician follow-up related to orthosis prescription and clinical reassessment
    L3920Cervical orthosis, occipital-mandibular (OMI), prefabricated, includes fitting and adjustmentsRelated orthotic code for cervical components; used when separate cervical device provided alongside CTLSO
    L0454Corset, lumbar-sacral, with or without shoulder straps, elasticAlternative lumbar support product code used in conservative spine management

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    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…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    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…
    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…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    225100000X
    208000000X
    207V00000X
    363A00000X
    156FC0800X
    163WU0100X
    2084F0202X
    385HR2055X

    Related ICD-10-CM Codes

    23 rows

    ICD-10-CM CodeDescription
    M41.9Scoliosis, unspecified
    M43.14Spondylolisthesis, thoracic region
    M43.16Spondylolisthesis, lumbar region
    M47.816Spondylosis without myelopathy or radiculopathy, lumbar region
    M47.817Spondylosis without myelopathy or radiculopathy, lumbosacral region
    M48.02Spinal stenosis, cervical region
    M48.04Spinal stenosis, thoracic region
    M51.26Other intervertebral disc displacement, lumbar region
    M51.27Other intervertebral disc displacement, lumbosacral region
    M53.2X4Spinal instabilities, thoracic region

    Showing 1–10 of 23

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Patient-Controlled End Range of Motion Stretching DevicesBluecross Idaho2027-01-01
    Sleep Position Trainerregence2027-01-01
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Continuous Passive Motion Devices with Remote Monitoring or Adaptive CapabilitiesBlue Cross Blue Shield - Rhode Island2026-12-01
    Bone Growth StimulatorsMass General Brigham Health Plan2026-12-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-12-01
    Patient Liftsuniverahealthcare2026-11-16
    Durable Medical Equipment RepairsCareSource Georgia2026-11-01
    Custom Compression GarmentsModa Health2026-11-01
    Tonic Motor Activation (TOMAC) for Restless Legs Syndromeregence2026-11-01

    Related Codes

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

    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

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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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