HCPCS Code L0643

Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
Short DescriptionLso sag ctr rigi pos pre ots
Year2026
Coverage CodeC = Carrier judgment
Action CodeN = No maintenance for this code
Action Effective DateJanuary 01, 2014
Code Added DateJanuary 01, 2014
Pricing Indicator38 = Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Type of ServiceP = Lump sum purchase of DME, prosthetics, orthotics