L1250 — Addition to tlso, (low profile), anterior asis pad
L1250 is a HCPCS Level II code for addition to tlso, (low profile), anterior asis pad. 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 L1250 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
- 0 — never payable MAI 3 — Date of Service Edit: Clinical · CMS Policy
- outpatient
- 2 units MAI 3 — Date of Service Edit: Clinical · Nature of Equipment
- DME supplier
- 2 units 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 L1250
- Long descriptor
- Addition to tlso, (low profile), anterior asis pad
- Short descriptor
- Anterior asis pad
- Added
- January 1, 1988
- BETOS
- D1F
- Pricing indicator
- 38 — 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.
Orthotics, prosthetics, prosthetic devices and vision services. Price subject to floors and ceilings.
Codes adjacent to L1250
HCPCS has no hierarchy — related items simply sit next to each other in the numbering. If L1250 is not quite right, the correct code is very often within a few positions of it.
- L1100Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather
- L1110Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model
- L1120Addition to ctlso, scoliosis orthosis, cover for upright, each
- L1200Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only
- L1210Addition to tlso, (low profile), lateral thoracic extension
- L1220Addition to tlso, (low profile), anterior thoracic extension
- L1230Addition to tlso, (low profile), milwaukee type superstructure
- L1240Addition to tlso, (low profile), lumbar derotation 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
- L1499Spinal orthosis, not otherwise specified
Questions about L1250
What is HCPCS code L1250?
L1250 is a HCPCS Level II code for addition to tlso, (low profile), anterior asis pad. It sits in the Orthotic and Prosthetic Procedures and Devices section.
Does Medicare cover L1250?
The CMS HCPCS file marks L1250 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.