Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf
Medicare coverage: Carrier judgment
Status: active (October 2026 file)
Medically Unlikely Edits (effective October 1, 2026)
Practitioner: max 0 units per day (clinical), rationale: CMS Policy
Outpatient hospital: max 1 units per day (policy), rationale: Anatomic Consideration
DME supplier: max 1 units per day (policy), rationale: Anatomic Consideration
Medicare pricing for L0467
DMEPOS fee schedule, July 2026 (DME26-C)
no modifier, prosthetics and orthotics (PO): non-rural $133.07 to $302.10 in the contiguous states; $276.04 to $523.52 in AK, HI, PR and VI; rural $365.71 to $437.27
Payer policies and prior authorization for L0467
Payer coverage policies that name L0467
L0467 appears in 4 coverage policies from Aetna, Anthem, Cigna.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.