Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1070-trapezius-sling-addition-ct-lso-scoliosis-orthosis
    Ask Trek AI about this page

    HCPCS Level II L1070: Trapezius Sling Addition to Scoliosis Orthosis

    HCPCS Level II code L1070 describes an addition to a custom trunk-limiting scoliosis orthosis (CTLSo) or scoliosis orthosis consisting of a trapezius sling used to provide support and positioning of the shoulder/upper thoracic region; service type is an orthotic accessory/addition, and the typical site of service is an outpatient orthotics/prosthetics clinic or durable medical equipment provider setting.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

    Customize your policy alerts

    Sign up for hcpcs L1070 policy alerts

    Get alerted when payer policies referencing L1070 are released or updated.

    Monitor payer policy activity

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

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 45-year-old patient with chronic upper thoracic scoliosis presents to an orthotics clinic for evaluation of persistent trapezial discomfort and shoulder girdle asymmetry while wearing a custom thoracolumbosacral orthosis (TLSO). The patient reports increased pain and suboptimal strap positioning causing pressure over the trapezius and decreased brace wear tolerance. The orthotist assesses fit, posture goals, and skin integrity and determines that an addition of a trapezius sling to the existing TLSO will redistribute strap forces, improve scapular positioning, and increase comfort.

    The clinical workflow includes: referral from the treating orthopedic surgeon or physiatrist; in-person orthotic evaluation and measurements; documentation of medical necessity tied to the underlying diagnosis (for example scoliosis, postural deformity, or neuromuscular weakness); fabrication or modification order placed; modification performed in the orthotics lab or clinic to attach a trapezius sling (L1070) to the existing TLSO; post-modification fitting and clinician education on donning, skin checks, and follow-up for adjustments.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, initial encounter, fitting and adjustment of orthosis, upper extremity, lower extremity, spinal, and other; may include associated componentsOften performed before or after L1070 fitting to train the patient in use of the modified TLSO with trapezius sling.
    97763Orthotic management and training, subsequent encounterUsed for follow-up visits to assess fit and function after addition of the trapezius sling.
    97035Ultrasound therapy, each 15 minutesSometimes used adjunctively in rehabilitation for soft tissue pain related to trapezial strain.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesCommonly billed by the prescribing clinician (orthopedist or physiatrist) documenting medical necessity for orthotic modification.
    20550Injection(s); single tendon sheath, or ligament, aponeurosis (e.g., trigger point injection)Occasionally performed by the treating clinician to address localized trapezial pain prior to orthotic modification; included here as a related service when clinically indicated.

    Note: Data not available in the input for directly supplied CPT–HCPCS crosswalks; the codes above are commonly associated in clinical workflow.

    Related Modifiers

    9 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…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    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…
    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…
    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 CodeSpecialtyNotes
    225100000XPhysical TherapistPhysical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    225XE1200XErgonomics Occupational TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers · Occupational Therapist
    207RG0100XGastroenterology PhysicianAn internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This…
    291900000XMilitary Clinical Medical LaboratoryA Department of Defense (DoD) medical clinical reference laboratory not associated with a DoD Hospital or DoD Clinic. An example is the Armed Forces I…
    2279P3900XNeonatal/Pediatric Registered Respiratory TherapistThe care and treatment of premature infants, newborns and children. This includes management of mechanical ventilation, assessment, diagnostics and g…
    103TB0200XCognitive & Behavioral PsychologistA psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cog…

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    G54.4Lumbosacral root disorders, not elsewhere classified
    M25.511Pain in right shoulder
    M25.512Pain in left shoulder
    M41.9Scoliosis, unspecified
    M43.6Torticollis
    M43.9Deforming dorsopathy, unspecified
    M50.20Other cervical disc displacement, unspecified cervical region
    M53.1Cervicobrachial syndrome
    M54.2Cervicalgia
    M54.6Pain in thoracic spine

    Showing 1–10 of 22

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    5 rows

    PolicyPayerEffective Date
    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
    General Durable Medical Equipment (DME) Medical GuidelineWPS Health Insurance2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    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

    • More pages

    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.
    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.