2025 HCPCS Code L0633

Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, 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 pendulous junction reduce customized strength produces pressure intracavitary include intervertebral abdomen extends rigid lateral expertise patient shoulder prefabricated sacrococcygeal specific provided

Short DescriptionLso sc r pos/lat pnl pre cst
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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