Summary & Overview
HCPCS L1652: Hip Orthosis with Bilateral Thigh Cuffs and Abductor Spreader Bar
HCPCS Level II code L1652 represents a prefabricated adult hip orthosis with bilateral thigh cuffs and an adjustable abductor spreader bar, including fitting, adjustment, and necessary patient-specific customization. This orthotic addresses conditions requiring stabilization or abduction control of the hips — important for postoperative management, neuromuscular disorders, and certain gait abnormalities. Nationally, the code matters because it defines coverage and billing parameters for a specialized orthotic that often involves both device supply and clinical fitting services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical function of the device, typical settings where the service is provided, and what payers commonly consider when adjudicating claims for prefabricated but customized hip orthoses. The publication outlines benchmarks and payment considerations, relevant policy updates affecting orthotic supplies and fitting services, and the clinical context for device use. It highlights standard billing practice elements and common modifiers and provides direction on where to locate payer-specific coverage policies. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
HCPCS Level II code L1652 describes a hip orthosis with bilateral thigh cuffs and an adjustable abductor spreader bar, adult size. The item is prefabricated and includes fitting and adjustment, and may be trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by a qualified individual.
Service Type: Durable medical equipment / orthotic device provision and customization
Typical Site of Service: Outpatient orthotics/prosthetics clinic, durable medical equipment provider location, or hospital outpatient setting
Data not available in the input for associated taxonomies, ICD-10 diagnoses, and related codes.
Clinical & Coding Specifications
Clinical Context
A 68-year-old ambulatory adult with bilateral hip osteoarthritis and recurrent subluxation following total hip arthroplasty presents to an orthotics clinic after referral from an orthopedic surgeon. The patient reports pain with abduction and intermittent instability when transferring and ambulating at home. A certified orthotist performs an evaluation, documents range of motion, muscle strength, gait deviations, and the need for abduction control to prevent dislocation. A prefabricated adult hip orthosis with bilateral thigh cuffs and an adjustable abductor spreader bar (L1652) is selected, then trimmed, bent, and molded by the orthotist to fit the patient. The service includes fitting, adjustments, patient education on donning/doffing, skin checks, and documentation of medical necessity in the chart.
Typical clinical workflow:
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Referral from orthopedic surgeon or primary care for mechanical instability or protection after hip surgery
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Orthotic evaluation by certified orthotist with documentation of functional limitations and measurements
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Selection of prefabricated
L1652device and point-of-care customization (trimming/molding/assembly) -
Fitting and adjustment visit with patient education and tolerance testing
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Billing of
L1652with supporting clinical notes, measurements, and supplier customization details