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To bill for custom-fit lumbar-sacral orthoses (LSOs), you'll need to use HCPCS Level II codes, which are designed for healthcare products and services that fall outside the CPT system. All bracing and orthotic devices are categorized under the "L" series of HCPCS codes.
L0631
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
This code applies to custom-fit lumbar-sacral orthoses (LSOs) with rigid anterior and posterior panels, designed for sagittal control. These braces extend from the sacrococcygeal junction to the T-9 vertebra and reduce intervertebral disc load through intracavitary pressure. Features may include padding, shoulder straps, and a pendulous abdomen design. Tailored by healthcare professionals, these braces provide precise stabilization and ensure Medicare compliance for effective lumbar-sacral support.
Offers comprehensive stabilization and sagittal control for patients recovering from lumbar-sacral or thoracolumbar surgeries, such as spinal fusion or laminectomy.
Provides rigid support and motion restriction for managing lumbar-sacral fractures, ligament injuries, or severe soft tissue damage.
Reduces intervertebral disc load and supports the lumbar-sacral region for conditions such as degenerative disc disease, spondylosis, or lumbar stenosis, improving mobility and reducing pain.
Our extensive range of PDAC-approved braces ensures you'll find the perfect solution for every patient's unique needs. From off-the-shelf options to specialized supports, we provide high-quality products that meet stringent medical standards.
Our user-friendly online platform allows for quick and efficient product selection. Search by specific codes, patient conditions, or product features to find exactly what you need with minimal effort.
Access a wealth of educational resources including detailed fitting guides, instructional videos, and direct support from our team of bracing specialists. We're committed to supporting healthcare providers in delivering optimal patient care.
Benefit from competitive pricing, volume discounts, and our Provider Discount Program. We help you manage costs without compromising on the quality of patient care and support.
Save on wholesale orders and access exclusive volume discounts for your practice. Our program makes it easy to stock high-quality, PDAC-approved braces at competitive prices, ensuring your patients receive the best care while keeping your costs low.
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Join NowProvide your patients with professional-grade spinal stabilization using our custom-fit LSO back braces. Designed for precise sagittal control and Medicare compliance, these orthoses offer advanced support for a variety of clinical needs.
View Custom-Fit LSO Back Brace CollectionTo bill for DME, you’ll need proper documentation, including patient diagnosis, medical necessity, and a detailed prescription. Be sure to use the appropriate modifiers (e.g., KX, RT, LT) and maintain compliance with Medicare guidelines.
Brace Direct follows a direct-to-consumer model to offer affordable prices, upfront pricing transparency, and faster access to braces without the delays and complexities of insurance or Medicare billing. Many products are FSA and HSA eligible for added convenience.
Direct-to-Consumer Medical Braces & Supports: No Insurance Hassles
We offer an extensive range of PDAC-approved products, educational resources, and a user-friendly ordering platform. Additionally, our Provider Discount Program helps practices manage costs while delivering high-quality care.
PDAC (Pricing, Data Analysis, and Coding) approval ensures that a brace meets Medicare’s strict requirements for quality, design, and function. Using PDAC-approved products simplifies reimbursement processes and helps avoid claim denials.
For more details on Medicare’s coding and reimbursement guidelines for orthotics, visit the official Medicare website below.
Medicare's DME Coverage