2025 HCPCS Code L0624

Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated

TAGS: abdomen pendulous about sacroiliac custom rigid sacrum motion panels reduces include fabricated placed provides
Short DescriptionSio panel custom
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, 2006
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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