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    v1.0.31
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1001-infant-ct-ls-orthosis-immobilizer-prefabricated
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    HCPCS L1001: Infant Cervical Thoracic Lumbar Sacral Orthosis Immobilizer

    HCPCS Level II code L1001 describes a prefabricated infant cervical thoracic lumbar sacral orthosis (CTLSO) immobilizer that includes fitting and adjustment; the service is a durable medical equipment/prosthetic orthotic supply involving provision and in‑person fitting, typically performed in outpatient clinics, pediatric orthotics/orthopedics offices, or hospital outpatient departments where infant immobilization for spine support is required.

    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 full-term infant presents to a pediatric orthotics clinic after hospitalization for a suspected congenital cervical spine instability identified on neonatal exam and confirmed by imaging. The infant has neck hypotonia and feeding difficulty with concern for limited cervical control; the pediatric orthopedic surgeon prescribes a cervical thoracic lumbar sacral orthosis, infant size, prefabricated, to provide immobilization and support during initial outpatient stabilization. The clinical workflow includes: initial prescription and order from the pediatric orthopedic surgeon, scheduling of an orthotist fitting visit, measurement and selection of the prefabricated infant-sized immobilizer, in-person fitting and necessary adjustments, caregiver education on application, skin checks and wear-time instructions, documentation of medical necessity and device details in the infant’s medical record, and a follow-up visit to reassess fit and need for continued immobilization. Typical sites of service are outpatient orthotics/prosthetics clinics, pediatric orthopedic offices, hospital-based orthotics departments, and occasionally a skilled nursing or home visit if the infant cannot travel.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99203Office or other outpatient visit for the evaluation and management of a new patient, low to moderate complexityInitial pediatric orthopedic or orthotics evaluation that may result in the prescription for the infant orthosis.
    97760Orthotic management and training, upper extremity, lower extremity and/or trunk, initial encounter, each 15 minutesProfessional service for instruction and care related to orthosis use, fitting education, and caregiver training at the time of delivery.
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visitUse to bill for supplies related to fitting and adjustments not included in the orthosis HCPCS fee if payer allows.
    99456Work-related or medical disability examination (e.g., DOT) — example code for specialty evaluationsMay be used in related specialty documentation if required for disability or functional assessment; included here as occasionally relevant in broader workflow.
    99080Special reports and documentation (e.g., outside medical records)Use when additional documentation or outreach to payors is required for prior authorization or medical necessity justification.

    Related Modifiers

    6 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…
    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…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    332B00000X
    207P00000X
    363L00000X
    367A00000X
    273Y00000X
    204D00000X
    2080P0207X
    2080P0208X

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    G54.2Cervical root disorders, not elsewhere classified
    M43.10Spondylolisthesis, site unspecified
    M43.12Spondylolisthesis, cervical region
    M43.16Spondylolisthesis, lumbar region
    M48.07Spinal stenosis, lumbosacral region
    M48.08Spinal stenosis, sacral and sacrococcygeal region
    M50.21Other cervical disc displacement, high cervical region
    M51.26Other intervertebral disc displacement, lumbar region
    M51.27Other intervertebral disc displacement, lumbosacral region
    M54.2Cervicalgia

    Showing 1–10 of 21

    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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