2025 HCPCS code L3962

Prefabricated shoulder, elbow, wrist, and hand orthosis for abduction positioning, specifically designed for Erb's palsy, including fitting and adjustment.

Use L-codes for orthotic devices and ensure proper documentation of medical necessity.

Medical necessity for L3962 is established by demonstrating the functional limitations caused by Erb's palsy or a similar condition and how the orthosis improves the patient's condition and/or facilitates recovery.

The provider is responsible for prescribing, fitting, and adjusting the orthosis to ensure proper function and support for the patient's shoulder, arm, elbow, forearm, wrist, and hand, allowing for free movement of the fingers.This orthosis is used to immobilize the upper limb to facilitate recovery from conditions like Erb's palsy.

IMPORTANT L3960 (Shoulder, elbow, wrist and hand orthosis, abduction positioning, airplane design), L3961 (Shoulder, elbow, wrist and hand orthosis, shoulder cap design), L3967 (Shoulder, elbow, wrist and hand orthosis, abduction positioning, airplane design, thoracic component and support bar)

In simple words: This is a pre-made brace for the shoulder, elbow, wrist, and hand, used for Erb's palsy. It helps position the arm correctly and includes fitting and adjustments by a healthcare professional.

This code represents a prefabricated, shoulder, elbow, wrist, and hand orthosis designed for abduction positioning in cases of Erb's palsy.It includes the fitting and adjustment of the orthosis by the provider.The orthosis supports the arm in a position of abduction and lateral rotation, allowing for free movement of the fingers.It is used to immobilize the upper limb in a specific orientation to facilitate recovery.

Example 1: A newborn infant is diagnosed with Erb's palsy after a difficult delivery.The physician prescribes an L3962 orthosis to support the arm in the correct position and promote proper healing., A child with Erb's palsy experiences muscle weakness and limited range of motion in the affected arm.The physician uses an L3962 orthosis to provide support and improve functionality., An adult sustains an injury to the brachial plexus, resulting in Erb's palsy-like symptoms. The physician utilizes an L3962 orthosis to aid in recovery and improve arm function.

Documentation should include the diagnosis of Erb's palsy or a related condition, the medical necessity for the orthosis, the type of orthosis provided (L3962), the fitting and adjustment process, and the patient's response to treatment.

  • Specialties:Orthopedics, Pediatrics, Physical Medicine and Rehabilitation, Neurology
  • Place of Service:Office, Hospital Outpatient, Inpatient Hospital (if applicable)
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