All PlansCoverageMedium impact
Thoracic-Lumbo-Sacral Orthosis with Pneumatics
Blue Cross & Blue Shield of Mississippi·MS · Orthopedics, PM&R (Physical Medicine & Rehab), Pain Management +1 more·Medical Policy
Effective date
Mar 27, 2025
We identified it
Jun 20, 2026
Summary
This policy confirms that thoracic-lumbo-sacral orthoses with pneumatic inflation (such as the Orthotrac Pneumatic Vest) are considered investigational and not covered by insurance. The policy was reviewed on 03/27/2025 with no changes to the investigational status.
Action Required
Immediately: Billing team must verify that HCPCS code L1499 for pneumatic thoracic-lumbo-sacral orthoses is flagged as investigational/non-covered in billing system. Inform providers that these devices are not covered and patients must be notified of non-coverage before ordering. Claims submitted will be denied as investigational.