2025 HCPCS code L3650
(Active) Effective Date: N/A Orthotics and Prosthetics - Shoulder Orthotics L3650-L3678 Orthotic Procedures and services L0112-L4631 Feed
Prefabricated, off-the-shelf, figure-of-eight shoulder orthosis for abduction restraint. Includes fitting and adjustment.
Medical necessity must be established by documenting the underlying condition requiring the orthosis. The documentation should demonstrate how the device will improve the patient's functional status or prevent further injury.
A clinician (e.g., orthotist, physician, or therapist) is responsible for assessing the patient's need, selecting the appropriate orthosis, fitting and adjusting the device, and providing instructions for its use.
In simple words: This is a pre-made shoulder brace, like a figure eight, that helps limit arm movement. It's used to prevent shoulder dislocation and comes already made, but will be adjusted to fit the patient.
Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off the shelf. This orthosis is designed to restrict shoulder abduction (raising of the arm) and is prefabricated for general use, not custom-made. The code includes fitting and adjustment.
Example 1: A patient with a history of shoulder dislocations requires an orthosis to limit abduction and prevent recurrence., Post-operatively, a patient needs an abduction restrainer to protect the shoulder joint during healing., An athlete with a shoulder injury uses the orthosis for support and to restrict movement during rehabilitation.
Documentation should include the medical necessity for the orthosis (e.g., diagnosis, injury, or post-surgical status), the type of orthosis provided (L3650), and the fitting and adjustment performed.
- Specialties:Orthopedics, Sports Medicine, Physical Therapy, Occupational Therapy
- Place of Service:Office, Outpatient Hospital, Clinic, Skilled Nursing Facility