Dynamic List Information
Dynamic List Data
HCPCS Code
L0650
On Master List?
Yes
Prior Authorization Required?
Yes
F2F and Written Order Prior to Delivery?
Yes
Description: Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the- shelf