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Indications for Medical Necessity

TLSO Indications for Prescribed PT:

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Pt requires brace:
⃝     To reduce pain by restricting mobility to the trunk.
⃝     To facilitate healing following an injury to the spine or related soft tissue
⃝     To otherwise support weak spinal muscles OR deformed spine 

 

Clinical Note Requirements: Dictation must be exactly as shown above for the indication chosen.

TLSO

L0457

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Most common ICD-10 codes:

M47.894 - Other spondylosis, thoracic region

M48.04 - Spinal stenosis, thoracic region

M51.04 - Intervertebral disc disorders with myelopathy, thoracic region

M51.14 - Intervertebral disc disorders with radiculopathy, thoracic region

M51.34 - Other intervertebral disc degeneration, thoracic region

M54.14 - Radiculopathy, thoracic region

M54.5 Low back pain

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RX/DWO

TLSO Document Requirements: Signed/Dated RX, Clinicals with Indications. Up to date patient demographics with insurance information.

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