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    v1.0.31
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1006-scoliosis-orthosis-axilla-to-trochanter-rigid-lateral-frame
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    HCPCS Level II L1006: Scoliosis Orthosis, Axilla-to-Trochanter Rigid Frame

    HCPCS Level II code L1006 describes a prefabricated scoliosis orthosis customized for a specific patient that provides sagittal and coronal control via a rigid lateral frame extending from the axilla to the trochanter and includes all accessory pads, straps and interface; this represents an orthotic device service typically provided by an orthotics/prosthetics supplier or brace clinic and is delivered in outpatient or durable medical equipment settings where fitting and device customization occur.

    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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    Clinical & Coding Specifications

    Clinical Context

    A 14-year-old adolescent presents to an orthotics clinic after referral from a pediatric orthopedic surgeon for progressive adolescent idiopathic scoliosis with a thoracolumbar curve measuring 28–38 degrees and documented progression over 6 months. The surgeon prescribes a prefabricated, customized scoliosis orthosis described by HCPCS code L1006 to provide sagittal and coronal control from the axilla to the trochanter. The clinical workflow includes: initial orthopedic evaluation and imaging (standing AP and lateral radiographs), measurement of Cobb angle and assessment of growth potential, orthotist evaluation and fitting, customization of a prefabricated rigid lateral-frame orthosis (trimming, bending, molding, adding pads and straps), and patient education on wear schedule and skin care. Follow-up visits at 6 weeks and then every 3 months include brace fit check, skin inspection, and repeat radiographs as ordered by the surgeon to evaluate curve control. Durable medical equipment documentation includes prescription, detailed measurements, description of customization performed by a qualified orthotist, and justification tied to documented curve magnitude and progression.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99203Office or other outpatient visit for the evaluation and management of a new patient, moderate complexityUsed for initial orthopedic or orthotist evaluation and documentation leading to prescription of L1006
    99213Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexityCommon for follow-up brace checks and ongoing management
    72020Radiologic examination, spine, entire thoracic and lumbar, 2 viewsBaseline or follow-up imaging to measure Cobb angle and assess brace effectiveness
    72146Radiologic examination, pelvis, single view; including trochanter region when clinically indicatedMay be used when assessing brace fit relative to trochanteric trim lines in complex cases
    97760Orthotic management and training, upper extremity, lower extremity and/or trunk, initial encounter; fitting and trainingUsed by orthotist or therapist for documented fitting, instruction, and patient education for L1006

    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…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207K00000X
    3336C0002X
    2080P0206X
    363L00000X
    175F00000X
    156FX1900X
    335U00000X
    101YS0200X

    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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