L3908 Who cock-up nonmolde pre ots

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for L3908

DMEPOS fee schedule, July 2026 (DME26-C)

Payer policies and prior authorization for L3908

1 of 1 payer prior-auth lists that name L3908 require prior authorization or set conditions: Medicare.

PayerPlanStatePrior authConditionsSinceSource
MedicareDMEPOS Probationary Prior Authorization (new suppliers)Allprior auth under conditionsNewly enrolled or changed-ownership suppliers in their probationary yearOct 15, 2026DMEPOS Probationary Prior Authorization List

Payer coverage policies that name L3908

L3908 appears in 2 coverage policies from Aetna, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaOrthopedic Casts, Braces and Splints (0009)covered if criteria are metJan 20, 2026payer document
AetnaOrthopedic Casts, Braces and Splints (0009)listed, no stance (range L3650-L4398)Jan 20, 2026payer document
CignaOrthotic Devices and Shoes (0543)covered if criteria are metSep 15, 2026payer document

Recent prior-auth changes

  • Jul 1, 2024: PA removed, Blue Shield of California Promise Health Plan

Medicaid fee-for-service

Prior authorization required or conditional in LA, MA, MS, NY, VA, WV.

  • AZ: $83.61 (dme), effective Oct 1, 2026
  • CO: $46.24 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $18.73 (dme, OS), effective Jul 1, 2026
  • IL: $26.12 (dme), effective Jan 1, 2026
  • IN: $68.33 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $54.76 (default, OUTPATIENT SERVICES - FOR OUTPATIENT HOSPITAL CLAIMS), effective Jul 1, 2026
  • KY: $42.10 (dme), effective Jan 1, 2026
  • LA: $36.57 (dme), effective Jul 1, 2012
  • MA: $68.73 (orthotics_prosthetics_rates), effective Apr 1, 2024
  • MD: $64.29 (dme), effective Apr 1, 2026
  • MS: $53.90 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (dme), effective Aug 1, 2026
  • NE: $58.78 (dme), effective Jul 1, 2026
  • NY: $47.98 (dme), effective Jul 1, 2026
  • OH: $43.66 (dme), effective Jan 1, 2010
  • OK: $47.16 (dme), effective Jan 1, 2026
  • TX: $38.25 (dmepos_tos_9_e_j_l_and_r, Hospital - Long Term, Limited, Or Specialized Ca, facility), effective Apr 1, 1992
  • VA: $68.08 (dme), effective Dec 1, 2026
  • VT: $75.29 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $86.68 (prosthetics_orthotics), effective Jul 1, 2026
  • WY: $46.10 (professional), effective Jan 1, 2021

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.