Dynamic List Information
Dynamic List Data
HCPCS Code
L0636
On Master List?
Yes
Prior Authorization Required?
No
F2F and Written Order Prior to Delivery?
Yes
Description: Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, 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, anterior panel, pendulous abdomen design, custom fabricated