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
| Short Description | Lso s/c shell/panel prefab |
|---|---|
| Year | 2026 |
| Coverage Code | C = Carrier judgment |
| Action Code | N = No maintenance for this code |
| Action Effective Date | January 01, 2014 |
| Code Added Date | January 01, 2006 |
| Pricing Indicator | 38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| Type of Service | P = Lump sum purchase of DME, prosthetics, orthotics |