2025 HCPCS Code L0639

Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

TAGS: customized stabilizing expertise patient anterior provided symphysis overlapping prefabricated pendulous overall intervertebral sacrococcygeal junction abdomen pressure include individual pubis extends specific reduce intracavitary rigid strength posterior produces material
Short DescriptionLso s/c shell/panel prefab
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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