L0638 HCPCS - LUMBAR-SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR FRAME/PANELS, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9 VERTEBRA, LATERAL STRENGTH PROVIDED BY RIGID LATERAL FRAME/PANELS, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON INTERVERTEBRAL DISCS, INCLUDES STRAPS, CLOSURES, MAY INCLUDE PADDING, SHOULDER STRAPS, PENDULOUS ABDOMEN DESIGN, CUSTOM FABRICATED

Code Information

HCPCS Code: L0638
Sequence Number: 0010
Short Description: Lso sag-coronal panel custom
Long Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
Date Added: 1/1/2006
Action Code: N - No maintenance for this code
Action Effective Date: 1/1/2006
Classification: Orthotic/Prosthetic Procedures
Coding System: HCPCS

Pricing Indicator Code:
- 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
Multiple Pricing Indicator Code: A - Not applicable as HCPCS priced under one methodology
Coverage Issues Manual Reference Section Number:
N/A
Medicare Carriers Manual Reference Section Number:
N/A
Coverage Code: C - Carrier judgment

Field Name	Field Value
Healthcare Common Procedure Coding System Code	L0638
HCPCS Sequence Number	0010
HCPCS Record Identification Code	3 - First line of procedure record also contains detail information in positions 92-275
HCPCS Long Description	Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated
HCPCS Short Description	Lso sag-coronal panel custom
HCPCS Pricing Indicator Code 1	38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
HCPCS Multiple Pricing Indicator Code	A - Not applicable as HCPCS priced under one methodology
HCPCS Coverage Code	C - Carrier judgment
HCPCS Berenson-Eggers Type Of Service Code	D1F - Prosthetic/Orthotic devices
HCPCS Type Of Service Code 1	P - Lump sum purchase of DME, prosthetics, orthotics
HCPCS Anesthesia Base Unit Quantity	0
HCPCS Code Added Date	1/1/2006
HCPCS Action Effective Date	1/1/2006
HCPCS Action Code	N - No maintenance for this code