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HCPCS Level II · Orthotic and prosthetic procedures and devices

L0458Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment

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Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.

About L0458

L0458 is an HCPCS Level II code in the L series (orthotic and prosthetic procedures and devices), describing tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment.

It was added to HCPCS effective 01/01/2003.

Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.

Details

Short description
Tlso 2mod symphis-xipho pre
Date added
01/01/2003
Action effective
01/01/2003
BETOS
D1F

Related L04xx codes

Common questions about L0458

Is HCPCS L0458 still valid?

Yes. L0458 is active in the CMS October 2026 HCPCS file.

Does Medicare cover L0458?

Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.