HCPCS Level II L1831: Knee Orthosis, Locking Joint, Positional, Prefab

HCPCS Level II code L1831 describes a prefabricated knee orthosis with locking knee joint(s) used as a positional orthosis, and includes fitting and adjustment; the service is an orthotic supply and fitting event typically provided in an outpatient clinic, orthotics/prosthetics supplier, or durable medical equipment setting for patients requiring knee stabilization or positional control.

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HCPCS Level II L1831: Knee Orthosis, Locking Joint, Positional, Prefab

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Clinical & Coding Specifications

Clinical Context

A typical patient is an adult who presents to an orthopedic clinic or durable medical equipment (DME) provider with knee instability, post‑operative immobilization needs, or a temporary requirement for positional support after injury or surgery. The patient may have acute ligamentous injury (e.g., partial anterior cruciate ligament tear), a distal femur or proximal tibia fracture managed nonoperatively or post‑op, or a neurologic condition causing knee buckling. After evaluation, the orthopedist documents medical necessity and prescribes a prefabricated knee orthosis with locking knee joint(s) to maintain a set position for stability or protection.

The clinical workflow typically includes:

Initial orthopedic or urgent care evaluation with history, physical exam, and imaging as indicated (plain radiographs; occasionally MRI).
Documentation of diagnosis, functional limitations, and need for a positional/locking knee orthosis in the plan of care.
Prescription for the orthosis L1831 with specifics (side, duration, weight bearing status, positioning/locking requirement).
Referral to a DME supplier for measurement, selection of a prefabricated orthosis, fitting, patient education, and adjustments.
Follow‑up visits with the orthopedic provider to assess fit, skin integrity, function, and to modify locking position or transition to a different device as healing progresses.

Typical sites of service: outpatient orthopedics clinic, durable medical equipment supplier location, outpatient physical therapy clinic for fitting/education, or hospital outpatient department for immediate post‑operative needs.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common pre‑provision evaluation and documentation of medical necessity prior to prescribing `L1831`
`99070`	Supplies and materials (except spectacles) provided by the physician over and above those usually included with the office visit	Used rarely when additional supplies or custom fitting materials are provided in clinic alongside orthosis fitting
`97760`	Orthotic(s) management and training, upper extremity, lower extremity and/or trunk, initial encounter; 15 minutes	Physical therapy code used for training and management of orthosis use and gait/transfer training after provision
`97763`	Orthotic/prosthetic management and training, upper and lower extremity, subsequent	Used for follow‑up orthotic training and adjustments after initial fitting
`99080`	Services provided in the course of furnishing medical records or information (e.g., medical necessity documentation)	Used when payors require additional documentation or administrative services related to prior authorization or appeals

Related Modifiers

5 rows

Modifier	Description	When to Use
52	Modifier ‑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…
59	Modifier 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…
78	CPT 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…
22	Modifier –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…
23	Modifier -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…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
2086S0102X	Surgical Critical Care Physician	A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critica…
213E00000X	Podiatrist	A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that l…
193200000X	Multi-Specialty Group	A business group of one or more individual practitioners, who practice with different areas of specialization.
2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	An individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Tec…
183700000X	Pharmacy Technician	A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professi…
1835I0206X	Infectious Diseases Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in the use of microbiology and pharmacology to develop, implement, and moni…
207RC0200X	Critical Care Medicine (Internal Medicine) Physician	An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for…

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

Frequently Asked Questions

References

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.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.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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Clinical & Coding Specifications

Clinical Context

The clinical workflow typically includes:

Initial orthopedic or urgent care evaluation with history, physical exam, and imaging as indicated (plain radiographs; occasionally MRI).
Documentation of diagnosis, functional limitations, and need for a positional/locking knee orthosis in the plan of care.
Prescription for the orthosis L1831 with specifics (side, duration, weight bearing status, positioning/locking requirement).
Referral to a DME supplier for measurement, selection of a prefabricated orthosis, fitting, patient education, and adjustments.
Follow‑up visits with the orthopedic provider to assess fit, skin integrity, function, and to modify locking position or transition to a different device as healing progresses.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`99213`	Office or other outpatient visit for the evaluation and management of an established patient, typically 15 minutes	Common pre‑provision evaluation and documentation of medical necessity prior to prescribing `L1831`
`99070`	Supplies and materials (except spectacles) provided by the physician over and above those usually included with the office visit	Used rarely when additional supplies or custom fitting materials are provided in clinic alongside orthosis fitting
`97760`	Orthotic(s) management and training, upper extremity, lower extremity and/or trunk, initial encounter; 15 minutes	Physical therapy code used for training and management of orthosis use and gait/transfer training after provision
`97763`	Orthotic/prosthetic management and training, upper and lower extremity, subsequent	Used for follow‑up orthotic training and adjustments after initial fitting
`99080`	Services provided in the course of furnishing medical records or information (e.g., medical necessity documentation)	Used when payors require additional documentation or administrative services related to prior authorization or appeals

Related Modifiers

5 rows

Modifier	Description	When to Use
52	Modifier ‑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…
59	Modifier 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…
78	CPT 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…
22	Modifier –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…
23	Modifier -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…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207X00000X	Orthopaedic Surgery Physician	An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated…
2086S0102X	Surgical Critical Care Physician	A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critica…
213E00000X	Podiatrist	A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that l…
193200000X	Multi-Specialty Group	A business group of one or more individual practitioners, who practice with different areas of specialization.
2279P1006X	Pulmonary Function Technologist Registered Respiratory Therapist	An individual who is trained and qualified to perform pulmonary diagnostic tests. In the course of conducting these tests, the Pulmonary Function Tec…
183700000X	Pharmacy Technician	A person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professi…
1835I0206X	Infectious Diseases Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill in the use of microbiology and pharmacology to develop, implement, and moni…
207RC0200X	Critical Care Medicine (Internal Medicine) Physician	An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for…

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

Frequently Asked Questions

References

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.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.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.

OpenPayer

HCPCS Level II L1831: Knee Orthosis, Locking Joint, Positional, Prefab

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HCPCS Level II L1831: Knee Orthosis, Locking Joint, Positional, Prefab

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS Level II L1831: Knee Orthosis, Locking Joint, Positional, Prefab

Sign up for hcpcs L1831 policy alerts

HCPCS Level II L1831: Knee Orthosis, Locking Joint, Positional, Prefab

Sign up for hcpcs L1831 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L1831 represent and where is it typically provided?

Which modifiers are commonly used with L1831 and when should they be applied?

In what clinical situations and workflow is L1831 typically used?

What other CPT codes or services are commonly billed with L1831?

Which diagnoses are considered clinically relevant for prescribing a prefabricated locking knee orthosis under L1831?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L1831 represent and where is it typically provided?

Which modifiers are commonly used with L1831 and when should they be applied?

In what clinical situations and workflow is L1831 typically used?

What other CPT codes or services are commonly billed with L1831?

Which diagnoses are considered clinically relevant for prescribing a prefabricated locking knee orthosis under L1831?

References