HCPCS code L0628 — Lso flex no ri stays pre ots.
Status: Active.
Effective Jan 1, 2014.
Source: CMS HCPCS Level II.
L0628
ActiveLso flex no ri stays pre ots
Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf
Category:
Orthotics & Prosthetics
Section:
L-codes: Orthotic and Prosthetic Procedures
Effective:
Jan 1, 2014
Code type:
alphanumeric
OPPS Status:
A
— Paid under a separate fee schedule (not OPPS)
MUE — Medically Unlikely Edits
Maximum units of L0628 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