Suggested HCPCS Code: L3760/L3761

• Provides prolonged low load passive stretch and treats hyper extension of the elbow
• Adjustable dials allow gradual changes to move the joint toward normal alignment
• Brace provides 3-point leverage similar to manual stretching, improving range of motion
• Padding provides comfort and redistributes skin pressure

Underlying Conditions:

• Elbow Contracture
• Rheumatoid Arthritis
• Hemarthrosis of Elbow
• Felty’s Syndrome of Elbow

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of elbow. (Not preventative.)  

Suggested HCPCS Code: L3760/L3761

• Air technology uses an air bladder at the inside of the elbow, positioned parallel to the arm to redistribute skin pressure
• Bilateral hinged uprights work with the air bladders to continue to move the joint toward normal alignment
• Hinges can be removed for the most severe flexion and added as the range improves

Underlying Conditions:

• Elbow Contracture
• Rheumatoid Arthritis
• Hemarthrosis of Elbow
• Felty’s Syndrome of Elbow

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of elbow. (Not preventative.)  

Suggested HCPCS Code: L3760/L3761

• Adjustable dials allow gradual changes to move joint toward normal alignment
• High-temperature plastic cuffs can be remolded to custom fit patient’s upper and lower arms
• Flex Technology splint moves with the patient’s abnormal muscle tone/spasticity
• Padding provides comfort and redistributes skin pressure
• Brace provides 3-point leverage similar to manual stretching, improving range of motion
• Lower cuff swivels to allow for varying degrees of flexion

*Available in more sizes as well as custom sizing. 

Underlying Conditions:

• Elbow Contracture
• Rheumatoid Arthritis
• Hemarthrosis of Elbow
• Felty’s Syndrome of Elbow

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of elbow. (Not preventative.) 

Suggested HCPCS Code: L3760/L3761

• Assists with elbow extension Easy to use pull ring and lock mechanism Six possible positions No additional tools necessary.

Underlying Conditions:

• Elbow Contracture
• Rheumatoid Arthritis
• Hemarthrosis of Elbow
• Felty’s Syndrome of Elbow

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of elbow. (Not preventative.)  

Suggested HCPCS Code: L3980

• Lightweight, durable, and cannot absorb moisture
• Trimmable polyethylene and lined with closed-cell foam
• Allows a range of motion at the shoulder and elbow

Underlying Conditions:

• Fracture of the shaft of the Humerus
• Fracture of the surgical neck of Humerus
• Displaced fracture of the tuberosity of Humerus

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of upper body. (Not preventative.)

Suggested HCPCS Code: L3960

• Aluminum waistband is moldable to patient torso and prevents anterior migration
• Brace positions include gunslinger, neutral plane and external rotation
• One-hand buckles ease patient reapplication
• Universal sling design to fit every patient with one brace
• Unique pistol grip adjusts with quick-pull tabs and keeps the arm from migrating forward out of the sling

Underlying Conditions:

• Frozen Shoulder
• Primary Osteoarthritis
• Shoulder Bicipital Tendinitis
• Shoulder Post Traumatic Osteoarthritis
• Impingement Syndrome
• Arthritis of Shoulder

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of upper body. (Not preventative.)

Suggested HCPCS Code: L3670

• Sling is available in 2 styles. One arm or bilateral
• Improves gait and balance
• Supports arm(s) in a functional position
• Reduced shoulder subluxation and shoulder pain
• Allows controlled arm swing

Underlying Conditions:

• Frozen Shoulder
• Primary Osteoarthritis
• Shoulder Subluxation
• Impingement Syndrome
• Arthritis of Shoulder
• Brachial Plexis Injury
• Post Polio Syndrome
• Transverse Myelitis
• Central Cord Syndrome

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of upper body. (Not preventative.) 

Suggested HCPCS Code: L3670

• Soft cotton/poly blend for increased comfort
• Removable foam waist strap
• D-ring on strap for easy adjustment
• Fits right or left arm

Underlying Conditions:

• Fracture of Shaft of Clavicle
• Fracture of Sternal End of Clavicle
• Sprain of the Shoulder or Elbow
• Stiffness of Shoulder not Elsewhere Classified
• Elbow Fracture
• Ulna Fracture

Coverage Criteria: 

• Item is for treatment of illness or injury or to improve function of upper body. (Not preventative.)