HCPCS Code L0623

Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf
Short DescriptionSio rig pnl pelv/sac pre ots
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2014
Code Added DateJanuary 01, 2006
Pricing Indicator38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Type of ServiceP = Lump sum purchase of DME, prosthetics, orthotics