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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1290-tlso-lateral-trochanteric-pad-low-profile
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    HCPCS L1290: Addition to TLSO, Low-Profile Lateral Trochanteric Pad

    HCPCS Level II code L1290 describes a low-profile lateral trochanteric pad supplied as an addition to a thoracolumbosacral orthosis (TLSO), intended to provide lateral hip/greater trochanter protection and pressure redistribution; service type is orthotic accessory/supply, and the typical site of service is outpatient orthotics/prosthetics clinic or durable medical equipment supplier.

    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.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult with an existing thoracolumbosacral orthosis (TLSO) who requires a targeted lateral trochanteric pad to offload pressure over the greater trochanter and improve lateral hip comfort while wearing a low-profile TLSO. The patient often presents to an orthotics clinic following spine stabilization for degenerative lumbar disease, thoracolumbar fracture, or post‑operative spinal fusion who reports lateral hip pain, skin irritation, or focal pressure over the trochanter while wearing their brace.

    The clinical workflow: the patient is evaluated by an orthotist or spine specialist who documents the indication, skin inspection, and functional impact of the trochanteric pressure. A prescription for the TLSO addition L1290 (addition to TLSO, low profile, lateral trochanteric pad) is written by the treating provider. The orthotics technician fits and positions the pad on the existing low‑profile TLSO, adjusts padding for pressure relief and gait balance, and documents fit, measurements, materials used, and patient tolerance. The device is delivered with instructions for wear, skin monitoring, and follow‑up. Typical sites of service include an outpatient orthotics/prosthetics clinic, hospital orthotics service, or a durable medical equipment supplier with trained orthotic staff.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97530Therapeutic activities, direct (one-on-one) patient contact by the provider, face-to-face; each 15 minutesPerformed by physical or occupational therapists to assess function and train patient in safe use of TLSO with the trochanteric pad.
    97760Orthotic(s) management and training, upper extremity, lower extremity, and/or trunk, initial; 15 minutesUsed for training and management of orthotic device use, including fitting instruction for TLSO additions.
    99213Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutesEvaluation visit when provider documents need for TLSO pad addition and writes prescription.
    11730Avulsion of nail plate, partial or complete, singleData not directly related to TLSO; Data not available in the input.
    20610Arthrocentesis, aspiration and/or injection; major joint or bursa (e.g., hip)May be performed by the treating clinician for concurrent trochanteric bursitis prior to orthotic modification.

    Related Modifiers

    6 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…
    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…
    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…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…

    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…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207RI0001XClinical & Laboratory Immunology (Internal Medicine) PhysicianAn internal medicine physician who specializes in clinical and laboratory immunology disease management.
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    291U00000XClinical Medical Laboratory(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, c…
    2084P0015XPsychosomatic Medicine PhysicianPsychosomatic Medicine is subspecialty in the diagnosis and treatment of psychiatric disorders and symptoms in complex medically ill patients. This su…
    207LP2900XPain Medicine (Anesthesiology) PhysicianAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
    103TR0400XRehabilitation PsychologistA psychologist who specializes in the study and application of psychological principles on behalf of persons who have disability due to injury or illn…

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    G82.20Paraplegia, unspecified
    G83.4Cauda equina syndrome
    M16.11Unilateral primary osteoarthritis, right hip
    M16.12Unilateral primary osteoarthritis, left hip
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M25.551Pain in right hip
    M25.552Pain in left hip
    M25.561Pain in right knee
    M25.562Pain in left knee

    Showing 1–10 of 28

    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

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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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