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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l3984-wrist-fracture-orthosis-prefabricated
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    HCPCS Level II L3984: Upper Extremity Fracture Orthosis, Wrist, Prefabricated

    HCPCS Level II code L3984 describes a prefabricated upper extremity fracture orthosis for the wrist that includes fitting and adjustment; the service is an orthotic device supply with professional fitting performed in an outpatient clinic, orthotics/prosthetics facility, or ambulatory care setting for immobilization and support of wrist fractures.

    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 42-year-old right-hand–dominant patient presents to an outpatient orthopedics clinic after sustaining a distal radius fracture on the dominant wrist from a fall onto an outstretched hand. Radiographs confirm a nondisplaced distal radius fracture with acceptable alignment managed nonoperatively. The clinician determines a prefabricated wrist fracture orthosis is appropriate to immobilize the wrist, provide support during early healing, and allow limited functional use.

    During the clinical workflow the orthotist or trained clinic staff selects a prefabricated upper extremity fracture orthosis described by billing code L3984. The device is fitted and adjusted for proper fit, straps, and padding. The provider documents the indication, device model, fitting details, patient tolerance, and care instructions. Follow-up visits include reassessment of fit, monitoring for skin issues, and progression of activity as healing permits. If clinical status changes (increased swelling, cast intolerance, need for custom device), the treatment plan is revised and documented.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99203Office or other outpatient visit for the evaluation and management of a new patient, low to moderate complexityInitial physician evaluation and decision to provide a prefabricated wrist orthosis
    99213Office or other outpatient visit for the evaluation and management of an established patient, low to moderate complexityFollow-up visits for reassessment, fit checks, and progress monitoring
    73610Radiologic exam, wrist; 2 viewsInitial and follow-up imaging to confirm fracture alignment and healing during orthosis use
    99070Supplies and materials (except spectacles), provided by the physician over and above those usually included with the office visitUse when supplying non-routine adjunctive materials used in fitting (if payer allows)
    97760Assistive technology assessment; initial evaluation (low complexity)Occupational therapy assessment related to adaptive use of the orthosis and patient training

    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…
    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…
    P1Modifier P1 indicates an ASA Physical Status I — a normal healthy patient — and is appended to anesthesia CPT codes (00100–01999) based on the anesthesiologist’s clinical assessment. It documents the…- When to apply: Use modifier P1 on anesthesia CPT codes (00100–01999) when the anesthesia provider assigns ASA Physical Status I — a normal healthy patient (non‑smoker, minimal or no alcohol use).…
    93Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A…- When to use: Apply modifier -93 when a synchronous, real-time, two-way patient–provider encounter is conducted entirely via audio-only (telephone or other real-time interactive audio-only…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207P00000XEmergency Medicine PhysicianAn emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospit…
    2080P0207XPediatric Hematology & Oncology PhysicianA pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous disea…
    363L00000XNurse Practitioner(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision mak…
    225XE0001XEnvironmental Modification Occupational TherapistOccupational therapy practitioners are experts at identifying the cause of difficulties in performance of activities of daily living and instrumental …
    2080P0201XPediatric Allergy/Immunology PhysicianA pediatrician who specializes in the diagnosis and treatment of allergies, allergic reactions, and immunologic diseases in children.
    364SS0200XSchool Clinical Nurse SpecialistPhysician Assistants & Advanced Practice Nursing Providers · Clinical Nurse Specialist
    246R00000XPathology TechnicianAn individual with knowledge of specific techniques and instruments who performs all of the routine tests in a medical laboratory and who has the abil…
    103TW0100XDeactivated - Psychotherapy Women

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    G56.01Carpal tunnel syndrome, right upper limb
    M19.041Primary osteoarthritis, right hand
    M19.042Primary osteoarthritis, left hand
    M25.531Pain in right wrist
    M25.532Pain in left wrist
    M62.831Muscle spasm of calf
    M84.451APathological fracture, right femur, initial encounter for fracture
    M84.452APathological fracture, left femur, initial encounter for fracture
    M84.461APathological fracture, right tibia, initial encounter for fracture
    M84.462APathological fracture, left tibia, initial encounter for fracture

    Showing 1–10 of 27

    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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