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L0810 |
 |
Halo procedure, cervical halo incorporated into jacket vest
| short | Halo cervical into jckt vest |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L0820 |
 |
Halo procedure, cervical halo incorporated into plaster body jacket
| short | Halo cervical into body jack |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L0830 |
 |
Halo procedure, cervical halo incorporated into milwaukee type orthosis
| short | Halo cerv into milwaukee typ |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | | DME | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L0859 |
 |
Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material
| short | Mri compatible system |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction | | DME | 1.0 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
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L0861 |
 |
Addition to halo procedure, replacement liner/interface material
| short | Halo repl liner/interface |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Nature of Equipment | | DME | 1.0 | 2 Date of Service Edit: Policy | Nature of Equipment |
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