L1499 — Spinal orthosis, not otherwise specified
L1499 is a HCPCS Level II code for spinal orthosis, not otherwise specified. It belongs to the Orthotic and Prosthetic Procedures and Devices section. Whether Medicare pays it depends on the coverage rule below.
Medicare coverage: Carrier judgment
Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.
From the coverage field of the CMS Alpha-Numeric HCPCS File, release 2026Q3-Jul. This states Medicare’s position on the code, not on your particular claim.
Medically Unlikely Edits — units per day
The most units of L1499 Medicare will pay on one date of service. Bill more on a single line and it is denied. The limit is not the same in every setting, so the row that matters is the one matching the claim you are building.
- practitioner
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
- outpatient
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
- DME supplier
- 1 unit MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
The adjudication indicator decides whether exceeding the limit is worth appealing at all: MAI 1 is a line edit you can support with documentation, MAI 3 is a date-of-service edit that is also appealable, and MAI 2 is absolute — no documentation overrides it. CMS MUE 2026Q3.
The CMS record for L1499
- Long descriptor
- Spinal orthosis, not otherwise specified
- Short descriptor
- Spinal orthosis nos
- Added
- January 1, 1982
- BETOS
- D1F
- Pricing indicator
- 46 — DMEPOS
The official wording. This is what the code means.
CMS's 28-character form, which is what shows up on a remittance advice.
When CMS introduced the code.
Berenson-Eggers Type of Service — CMS's own analytic grouping.
Carrier priced — not otherwise classified, individual determination, carrier discretion, or gap-filled amounts.
Codes adjacent to L1499
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L1499 is not quite right, the correct code is very often within a few positions of it.
- L1250Addition to tlso, (low profile), anterior asis pad
- L1260Addition to tlso, (low profile), anterior thoracic derotation pad
- L1270Addition to tlso, (low profile), abdominal pad
- L1280Addition to tlso, (low profile), rib gusset (elastic), each
- L1290Addition to tlso, (low profile), lateral trochanteric pad
- L1300Other scoliosis procedure, body jacket molded to patient model
- L1310Other scoliosis procedure, post-operative body jacket
- L1320Thoracic, pectus carinatum orthosis, sternal compression, rigid circumferential frame with anterior and posterior rigid pads, custom fabricated
- L1600Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise
- L1610Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
- L1620Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
- L1630Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated
- L1640Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated
- L1650Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment
- L1652Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
- L1653Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, off the shelf
Questions about L1499
What is HCPCS code L1499?
L1499 is a HCPCS Level II code for spinal orthosis, not otherwise specified. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L1499?
The CMS HCPCS file marks L1499 as "Carrier judgment". Coverage is decided by your Medicare contractor, not by national policy. Whether this is paid depends on the LCD for your jurisdiction and on what the documentation supports.