HCPCS code L0635 — Lso sagit rigid panel prefab. Status: Active. Effective Jan 1, 2006. Source: CMS HCPCS Level II.

L0635

Active

Lso sagit rigid panel prefab

Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, 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, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment

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 L0635 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