HCPCS code L0622 — Sio flex pelvisacral custom.
Status: Active.
Effective Jan 1, 2006.
Source: CMS HCPCS Level II.
L0622
ActiveSio flex pelvisacral custom
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated
Category:
Orthotics & Prosthetics
Section:
L-codes: Orthotic and Prosthetic Procedures
Effective:
Jan 1, 2006
Code type:
alphanumeric
OPPS Status:
A
— Paid under a separate fee schedule (not OPPS)
MUE — Medically Unlikely Edits
Maximum units of L0622 Medicare will pay for one beneficiary on one date of service. Claims exceeding the MUE are denied or returned for review.
| Service Type | Max Units / Day |
|---|---|
| DME Supplier | 1 |
| Outpatient Hospital | 1 |
| Practitioner Services | 0 |
Source: CMS Medicare NCCI Medically Unlikely Edits