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: individual posterior pubis pendulous junction reduce customized overlapping specific strength produces pressure anterior intracavitary include intervertebral overall abdomen extends rigid expertise patient prefabricated material symphysis sacrococcygeal stabilizing provided
| Short Description | Lso s/c shell/panel prefab |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Action Effective Date | January 01, 2014 |
| HCPCS Code Added Date | January 01, 2006 |
| HCPCS Pricing Indicator Code | 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Coverage Issues Manual Reference Section Number | |
| HCPCS Type Of Service Code | P - Lump sum purchase of DME, prosthetics, orthotics |
| HCPCS Anesthesia Base Unit Quantity | 0 |
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