2025 HCPCS Code L0628
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
TAGS: abdomen pressure reduce intracavitary pendulous intervertebral posterior shoulder include produces extends provides sacrococcygeal junction| Short Description | Lso flex no ri stays pre ots |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Code Added Date | January 01, 2006 |
| HCPCS Action Effective Date | January 01, 2014 |
| HCPCS Pricing Indicator Code | 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| HCPCS Type Of Service Code | P - Lump sum purchase of DME, prosthetics, orthotics |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Anesthesia Base Unit Quantity | 0 |
| HCPCS Coverage Issues Manual Reference Section Number |
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