HCPCS code L0631 — Lso sag r an/pos pnl pre cst. Status: Active. Effective Jan 1, 2014. Source: CMS HCPCS Level II.

L0631

Active

Lso sag r an/pos pnl pre cst

Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

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 L0631 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