| HCPCS Code: |
L3969 |
| Long Description: |
Shoulder elbow orthosis, mobile arm support, monosuspension arm and hand support, overhead elbow forearm hand sling support, yoke type suspension support, prefabricated, includes fitting and adjustment |
| Short Description: |
Monosuspension arm/hand supp |
| Pricing Indicator 1: |
32 (Inexpensive & routinely purchased DME (price subject to floors and ceilings)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| Statute Number: |
|
| Cross Reference Code 1: |
E2630 |
| Coverage Code: |
C (Carrier judgment) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1D (Wheelchairs) |
| Type of Service Code 1: |
A (Used durable medical equipment (DME)) |
| Type of Service Code 2: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
| Type of Service Code 3: |
R (Rental of DME) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1988 |
| Action Effective Date: |
01-01-2012 |
| Termination Date: |
31-12-2011 |
| Action Code: |
N (No maintenance for this code) |
