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What is the CPT Code for a Custom-Fit LSO Back Brace with Sagittal-Coronal Control?

Custom-Fit LSO Back Brace with Sagittal-Coronal Control HCPCS Code L0637

To bill for custom-fit lumbar-sacral orthoses (LSOs) with sagittal-coronal control, 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.

HCPCS Code:

L0637

Definition:

Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on 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, posterior, and lateral panels for sagittal and coronal control. These braces extend from the sacrococcygeal junction to the T-9 vertebra, provide lateral strength, and reduce intervertebral disc load through intracavitary pressure. Designed with straps, closures, and optional padding or shoulder straps, these braces are customized by healthcare professionals to ensure optimal fit, stabilization, and Medicare compliance.

Clinical Use Cases for L0637 Custom-Fit LSO Back Braces

Post-Surgical Recovery

Offers sagittal and coronal control for patients recovering from lumbar-sacral or thoracolumbar spine surgeries, providing comprehensive stabilization and motion restriction.

Severe Lumbar-Sacral Injuries

Provides advanced support and motion restriction for complex lumbar-sacral injuries, including fractures, ligament injuries, or soft tissue trauma.

Spinal Deformities and Degenerative Conditions

Manages conditions such as scoliosis, degenerative disc disease, or lumbar stenosis by providing triplanar support and reducing intervertebral disc load to enhance mobility and reduce pain.

Why Healthcare Providers Choose Brace Direct

  • Customer Service at Brace Direct is efficient, knowledgeable, and helpful.

    Comprehensive Product Selection

    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.

  • Streamlined Ordering Process

    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.

  • Expert Clinical Support

    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.

Cost-Effective Solutions

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.

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Provider Discount Program

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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Earn commissions by referring patients to trusted, high-quality braces. Our Affiliate Program offers a seamless way to recommend PDAC-approved products to your patients while creating an additional revenue stream for your practice.

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Explore Our PDAC L0637 Approved Custom-Fit LSO Back Braces

Equip your practice with custom-fit LSO back braces designed for advanced sagittal and coronal control. Tailored by healthcare professionals, these braces ensure Medicare compliance and exceptional spinal stabilization for complex clinical needs.

View Custom-Fit LSO Back Brace Collection

Frequently Asked Questions

How can I ensure correct billing for DME (Durable Medical Equipment)? +

To 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.

Why doesn't Brace Direct work with insurance or Medicare? +

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

How does Brace Direct support healthcare providers? +

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.

What does PDAC approval mean, and why is it important? +

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.

Where can I learn more about Medicare's requirements for braces and billing? +

For more details on Medicare’s coding and reimbursement guidelines for orthotics, visit the official Medicare website below.
Medicare's DME Coverage

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