TLSO/LSO Coverage Criteria
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This policy governs Medicaid coverage and documentation requirements for thoracolumbosacral and lumbosacral orthoses (TLSO/LSO). Coverage applies when the device is medically necessary for trunk mobility restriction, spinal healing, spinal or trunk weakness, or spinal deformity.
The required physician or practitioner examination timeframe changed from 60 days to 90 days before the service authorization start date.
Service Authorization and CMN wording was replaced with instructions to use the Look-Up Tool to determine whether a code requires Service Authorization.
The policy was reviewed and reformatted without substantive coverage changes.
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