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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1210-tlso-low-profile-lateral-thoracic-extension
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    HCPCS L1210: TLSO Low-Profile Lateral Thoracic Extension

    HCPCS Level II code L1210 describes an addition to a thoracolumbosacral orthosis (TLSO), low-profile, lateral thoracic extension, used to extend the lateral thoracic support of a TLSO brace; service type: orthotic device component; typical site of service: outpatient orthotics/prosthetics clinic or durable medical equipment (DME) supplier.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Prior Authorization for Durable Medical Equipment (DME), Breast Pumps.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 14-year-old adolescent with progressive adolescent idiopathic scoliosis presents to an orthotics clinic after spinal imaging demonstrates a thoracic curve requiring bracing. The orthotist evaluates the patient for a custom thoracolumbosacral orthosis (TLSO) and documents need for a lateral thoracic extension to improve contouring and control of the upper thoracic curvature. The service performed is an addition to a low-profile TLSO to attach a lateral thoracic extension (L1210). The workflow includes measurement and fitting by a certified orthotist, fabrication or modification of the TLSO with the lateral extension, in-office fitting and adjustments, patient education on wear schedule and skin care, and documentation of medical necessity by the treating orthopedic surgeon or physiatrist. Typical sites of service are outpatient orthotics/prosthetics clinics, orthopedic offices, or hospital-based orthotics departments. The typical patient is an adolescent or adult with thoracic scoliosis, postoperative thoracic spinal stabilization requiring additional lateral support, or a neuromuscular condition causing lateral thoracic instability, requiring the extension to the existing low-profile TLSO for improved lateral control and comfort.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic management and training, upper extremity, lower extremity, and/or trunk, initial orthotic fit; includes assessment and fitting, and educationMay be billed when the patient receives initial fitting, training, and education for the TLSO with the lateral thoracic extension.
    97763Orthotic management and training, subsequent handling and follow-up of orthoses, established patientUsed for follow-up visits for adjustments and ongoing training after the TLSO addition.
    L3928Not a CPT code; HCPCS code for TLSO, thoracic-lumbar-sacral, adjustableListed here for clinical context; relates to primary TLSO to which L1210 is an addition.
    20550Injection(s) single tendon sheath, or ligament, tendon sheath injectionMay be unrelated; included only when an adjacent procedure for pain management is performed in the same clinical workflow.

    (If additional CPT codes were provided in the input, they would be listed here. The input did not include CPT codes beyond common orthotic management codes.)

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    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…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2083S0010XSports Medicine (Preventive Medicine) PhysicianA preventive medicine physician who specializes in the diagnosis and treatment of sports related conditions and injuries.
    231HA2400XAssistive Technology Practitioner AudiologistSpeech, Language and Hearing Service Providers · Audiologist
    208C00000XColon & Rectal Surgery PhysicianA colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by m…
    2278P1004XPulmonary Diagnostics Certified Respiratory TherapistIncluded in the area of pulmonary diagnostics are the following; collection and analysis of physiological specimens, interpretation of physiological d…
    207QB0505XDiabetology (Internal Medicine) PhysicianAn internist who specializes in diagnosis and management of type 1, type 2, gestational, and atypical diabetes; diabetes complications; hospital manag…
    207RA0001XAdvanced Heart Failure and Transplant Cardiology PhysicianSpecialists in Advanced Heart Failure and Transplant Cardiology would participate in the inpatient and outpatient management of patients with advanced…
    332G00000XEye BankAn eye bank procures and distributes eyes for transplant, education and research. To promote patient safety, donated eyes and donor medial histories a…
    1744P3200XProsthetics Case ManagementA case manager who provides services for patients with prosthetics.

    Related ICD-10-CM Codes

    22 rows

    ICD-10-CM CodeDescription
    G56.41Causalgia of right upper limb
    M41.9Scoliosis, unspecified
    M43.14Spondylolisthesis, thoracic region
    M43.16Spondylolisthesis, lumbar region
    M48.07Spinal stenosis, lumbosacral region
    M51.26Other intervertebral disc displacement, lumbar region
    M51.27Other intervertebral disc displacement, lumbosacral region
    M54.16Radiculopathy, lumbar region
    M54.17Radiculopathy, lumbosacral region
    M62.81Muscle weakness (generalized)

    Showing 1–10 of 22

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01
    Breast PumpsModa Health2026-09-01
    Personal Emergency Response SystemsCareSource Georgia2026-09-01
    Continuous Passive Motion (CPM) DevicesCigna2026-08-15
    Push-Rim Activated Power-Assist Device (E0986) — Manual Wheelchair Accessorymoda_health_plan_inc2026-08-13
    Beds and Mattresses (for Ohio Only)Colorado Rocky Mountain Health Plans2026-08-01
    Beds and Mattresses (for Kentucky Only)UnitedHealthcare2026-08-01
    Pneumatic Compression Devices (for Nebraska Only)UnitedHealthcare2026-08-01
    Indications for Coverage — Hospital beds, support surfaces, and safety enclosure beds (DME)Colorado Rocky Mountain Health Plans2026-08-01

    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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