Summary & Overview
HCPCS L1110: Ring Flange Addition to CTLSO or Scoliosis Orthosis
HCPCS Level II code L1110 denotes an addition to a cervicothoracolumbosacral orthosis (CTLSO) or scoliosis orthosis: a ring flange, constructed of plastic or leather and molded to the patient model. This orthotic component is used to provide structural support and hold corrective or stabilizing elements in place for patients receiving spinal bracing. The code matters nationally because orthotic additions affect device configuration, clinical fit, and billing for durable medical equipment and orthotics services across multiple payers.
Key payers covered in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise context on clinical use and typical service settings, an explanation of what this code represents, and guidance on where it commonly appears in service lines. The publication summarizes benchmarking and reimbursement context where available and highlights relevant billing themes for orthotic componentization and customization. If specific payer policy detail or pricing benchmarks are absent in the input, those items are noted as not available. The content is intended to orient clinicians, billers, and policy analysts to the clinical meaning and billing context of L1110 and to indicate what additional payer-specific information to seek for claims processing and coverage determination.
Billing Code Overview
HCPCS Level II code L1110 describes an addition to a CTLSO or scoliosis orthosis, specifically a ring flange made of plastic or leather molded to a patient model. This code denotes a custom-fitted component added to spinal bracing designed to support the cervical, thoracic, lumbar, and sacral regions for patients with spinal deformity or instability.
Service type: Orthotic component fabrication and customization
Typical site of service: Orthotics/prosthetics clinic, durable medical equipment supplier, outpatient rehabilitation center, or hospital-based orthotics lab
Clinical & Coding Specifications
Clinical Context
A 14-year-old adolescent with progressive idiopathic scoliosis is evaluated by an orthotist after referral from an orthopedic surgeon. The patient has an existing thoracolumbosacral orthosis (TLSO) and continues to have a prominence at the superior thoracic opening of the brace causing skin irritation and inadequate correction. The orthotist fabricates a custom-molded ring flange made of plastic or leather to be added to the TLSO to improve fit, distribute pressure, and reduce soft-tissue irritation. Typical workflow: initial orthotic assessment and measurements; review of the orthopedic prescription and ICD-10 diagnosis; creation of a patient model (cast or digital scan); molding and fabrication of the ring flange component; fitting session for adjustment; documentation of medical necessity, component description (L1110), date of service, modifier(s) if applicable, and any repair or replacement notes; final follow-up to assess fit, skin integrity, and function. Typical site of service: orthotics/prosthetics clinic or outpatient orthopedics department.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the addition requires substantially greater work than typical fabrication (extensive customization or complex molding). |