HCPCS code L0642 — Lo sag ri an/pos pnl pre ots. Status: Active. Effective Jan 1, 2014. Source: CMS HCPCS Level II.

L0642

Active

Lo sag ri an/pos pnl pre ots

Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, 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 L0642 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