HCPCS Code L0464: TLSO, Triplanar Control, Modular Segmented Spinal System

Use L0464 when providing a prefabricated TLSO with triplanar control that matches the full code description, including four rigid shells, overlapping lateral sections, and fitting/adjustment. Use L1499 only for miscellaneous spinal orthoses that do not match any existing L-code, with detailed documentation explaining why no specific code applies.

A certified orthotist or similarly trained professional must perform more than minimal self-adjustments, such as trimming, molding, or other modifications beyond what a patient or caretaker could perform.

Documentation must describe the specific adjustments made, the nature of the orthotist’s expertise, and the custom-fitting steps taken; this must be retained and available for payer review.