L1653 Ho abduction static otsHip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf
1 of 1 payer prior-auth lists that name L1653 require prior authorization or set conditions: Medicare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Medicare | DMEPOS Probationary Prior Authorization (new suppliers) | All | prior auth under conditions | Newly enrolled or changed-ownership suppliers in their probationary year | Oct 15, 2026 | DMEPOS Probationary Prior Authorization List |
L1653 appears in 1 coverage policy from Aetna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Orthopedic Casts, Braces and Splints (0009) | listed, no stance (range L1600-L2999) | Jan 20, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | listed, no stance (range L1600-L1690) | Jan 20, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | not covered (range L1600-L1690) | Jan 20, 2026 | payer document |
Prior authorization required or conditional in MA, MS, OH, VA.
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.