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
Short DescriptionSio panel custom
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2006
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