L1810 Ko elastic with jointsKnee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
2 of 2 payer prior-auth lists that name L1810 require prior authorization or set conditions: Medicare, UnitedHealthcare Community Plan.
| 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 |
| UnitedHealthcare Community Plan | Texas STAR+PLUS | TX | prior auth required | Jan 1, 2019 | Prior authorization requirements for STAR+Plus Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan STAR+PLUS health care p |
L1810 appears in 6 coverage policies from Aetna, Anthem, Blue Shield of California, Capital Blue Cross, Cigna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Knee Braces (1094) | covered if criteria are met | Jan 20, 2026 | payer document |
| Aetna | Knee Braces (1094) | listed, no stance (range L1810-L1860) | Jan 20, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | listed, no stance (range L1600-L2999) | Jan 20, 2026 | payer document |
| Anthem | Prefabricated and Prophylactic Knee Braces (CG-OR-PR-02) | covered if criteria are met | Feb 19, 2026 | payer document |
| Blue Shield of California | BSC1.05 | Knee Braces (Custom) | listed, no stance | payer document | |
| Capital Blue Cross | Knee Braces (MP 6.012) Procedure Codes | covered if criteria are met | Sep 1, 2026 | payer document |
| Cigna | Orthotic Devices and Shoes (0543) | covered if criteria are met | Sep 15, 2026 | payer document |
Prior authorization required or conditional in LA, MA, MS, NY, VA, WV.
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.