L0626 |
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Lumbar orthosis, sagittal control, with rigid posterior panel(s), 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, stays, 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
short | Lo sag rig pnl stays pre cst |
MUE | Location | Value | Ajudication Indicator | Rationale |
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PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | DME | 1.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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