HCPCS L0639 Code. Lso s/c shell/panel prefab


Table of content for "Lso s/c shell/panel prefab" (HCPCS L0639)

General information on the “L0639” code

HCPCS Code: L0639
Long Description: Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, 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 Description: Lso s/c shell/panel prefab

Original information is taken from L0639 page

Pricing indicators

Pricing Indicator Code 1: 38 – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) . Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology

Certification and additional reference information

Coverage

Coverage: C – Carrier judgment

Type of service


Berenson-Eggers Type of Service (BETOS): D1F – Prosthetic/Orthotic devices
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics

Misc information

Anesthesia Base Unit Quantity: 0
Code Added Date: 20060101
Code Effective Date: 20140101
Action Code: N – No maintenance for this code