HCPCS Range Knee Orthotics

• 1 Knee orthosis (KO), elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1810 )

• 2 Knee orthosis (KO), elastic with joints, prefabricated, off-the-shelf ( L1812 )

• 3 Knee orthosis (KO), elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment ( L1820 )

• 4 Knee orthosis (KO), immobilizer, canvas longitudinal, prefabricated, off-the-shelf ( L1830 )

• 5 Knee orthosis (KO), locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment ( L1831 )

• 6 Knee orthosis (KO), adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1832 )

• 7 Knee orthosis (KO), adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf ( L1833 )

• 8 Knee orthosis (KO), without knee joint, rigid, custom-fabricated ( L1834 )

• 9 Knee orthosis (KO), rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf ( L1836 )

• 10 Knee orthosis (KO), derotation, medial-lateral, anterior cruciate ligament, custom fabricated ( L1840 )

• 11 Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1843 )

• 12 Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated ( L1844 )

• 13 Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1845 )

• 14 Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated ( L1846 )

• 15 Knee orthosis (KO), double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise ( L1847 )

• 16 Knee orthosis (KO), double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf ( L1848 )

• 17 Knee orthosis (KO), swedish type, prefabricated, off-the-shelf ( L1850 )

• 18 Knee orthosis (KO), modification of supracondylar prosthetic socket, custom-fabricated (SK) ( L1860 )

• 19 Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf ( L1851 )

• 20 Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf ( L1852 )