Custom-Fit LSO Belt HCPCS Code L0626

To bill for custom-fit LSO belts, 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:

L0626

Definition:

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

This code applies to custom-fit lumbar sacral orthoses (LSOs) designed for sagittal control. These braces include rigid posterior panels extending from L-1 to below L-5 and may feature padding, stays, or a pendulous abdomen design. By producing intracavitary pressure, these LSOs reduce the load on intervertebral discs and provide effective lumbar support. Adjusted and customized by healthcare professionals, these braces ensure precise fit, stabilization, and Medicare compliance.

Clinical Use Cases for L0626 Custom-Fit Lumbar Orthoses

Post-Surgical Recovery

Provides targeted stabilization and sagittal control for patients recovering from lumbar surgeries, ensuring proper alignment and reducing strain during healing.

Lumbar Injuries

Offers rigid support and motion restriction to protect the spine and promote recovery from lumbar sprains, fractures, or other injuries.

Degenerative Spinal Conditions

Reduces intervertebral disc load and provides support for conditions such as degenerative disc disease, spondylosis, or lumbar stenosis, improving mobility and reducing pain.

Why Healthcare Providers Choose Brace Direct

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.

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.

Learn More

Become an Affiliate

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.

Join Now

Explore Our PDAC L0626 Approved Custom-Fit Lumbar Orthoses

Provide your patients with professional-grade spinal stabilization using our custom-fit lumbar orthoses. Designed for precise fit and effective sagittal control, these braces ensure Medicare compliance and optimal care.

View Custom-Fit Lumbar Orthosis 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

What is the CPT Code for a Custom-Fit LSO Belt?