HCPCS Code L0648

Official Description

Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, 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, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf

Short Descr	Lso sag r an/pos pnl pre ots
Coverage	Carrier Priced
Pricing Indicator(s)	38 – Supplies And Surgical Dressings - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
MPI	A – Not applicable, as HCPCS priced under one methodology
BETOS	D1F – Prosthetic/Orthotic devices
TOS Code(s)	P – Lump sum purchase of DME, prosthetics, orthotics
Added Date	1/1/2014
APC Status Indicator	Service Paid under Fee Schedule or Payment System other than OPPS
MUE	0
MUE	1
OTS Orthotic	No

KV	Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
KX	Requirements specified in the medical policy have been met
CG	Policy criteria applied
ST	Related to trauma or injury
KT	Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
GA	Waiver of liability statement issued as required by payer policy, individual case
GZ	Item or service expected to be denied as not reasonable and necessary
CC	Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR	Catastrophe/disaster related
EY	No physician or other licensed health care provider order for this item or service
GP	Services delivered under an outpatient physical therapy plan of care
GW	Service not related to the hospice patient's terminal condition
GX	Notice of liability issued, voluntary under payer policy
GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
J5	Off-the-shelf orthotic subject to dmepos competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional service
KS	Glucose monitor supply for diabetic beneficiary not treated with insulin
KY	Dmepos item subject to dmepos competitive bidding program number 5
LT	Left side (used to identify procedures performed on the left side of the body)
NU	New equipment
RA	Replacement of a dme, orthotic or prosthetic item
RT	Right side (used to identify procedures performed on the right side of the body)