Documents

To be used for reference only...

INFORMATION:

HCPC billing-Custom Fabricated vs. Pre-Fabricated

ICD-10 for TENS and Conductive Garment

ICD-10 for Spinal Orthoses

ICD-10 for Knee Orthoses

 

FORMS:

Proof of Delivery Form

LH DME Back Brace Delivery Ticket

ASSIGNMENT OF BENEFITS

LH DME Patient Packet

LETTERS OF MEDICAL NECESSITY

TENS:

Medicare TENS

TENS Unit/Garment (E0730/E0731)

Conductive Garment

 

TRUNK:

Multipost Therapy Collar (L0180)

Cervical Traction

Theratrak (E0849)

LSO/TLSO

LSO/TLSO with Custom Fit Options

Scoliosis Brace (L1005)

 

 

LOWER EXTREMITIES:

Knee Brace with Custom Fit Options

Knee Brace (L1812)

Knee Brace (L1830)

Knee Brace (L1832)

Knee Brace (L1833)

Knee Brace (L1843)

Knee Brace (L1845)

Knee Brace (L1851)

Knee Brace (L1852)

Knee (L2397/2795)

Ankle Brace (L1902)

Ankle Brace (L1971)

 

UPPER EXTREMITIES:

Elbow Brace (L3761)

WHFO (L3807)

WHFO (L3809)

SEWH (L3960)