2025 HCPCS code L0625
Flexible lumbar orthosis providing lumbar support, extending posteriorly from L1 to below L5, using intracavitary pressure to reduce load on intervertebral discs.
Medical necessity for a lumbar orthosis must be established through a diagnosis that indicates its use is appropriate, such as lower back pain due to injury or a condition requiring spinal support. Documentation should demonstrate the functional limitations and expected improvement with the orthosis. Payer policies regarding medical necessity criteria should be reviewed.
In simple words: This is a flexible back brace that supports the lower back from the first to the fifth lumbar vertebrae. It helps relieve pressure on the discs in the spine by applying gentle pressure to the abdomen. It has straps and closures to hold it in place and might also have additional features like shoulder straps and extra support for a protruding abdomen. It is ready-made and doesn't require custom fitting.
This flexible lumbar orthosis (LO) provides support to the lumbar region, extending posteriorly from the first lumbar vertebra (L1) down to below the fifth lumbar vertebra (L5). It utilizes intracavitary pressure to reduce the load on the intervertebral discs. The orthosis includes straps and closures and may also incorporate features such as a pendulous abdomen design, shoulder straps, and stays. It's prefabricated and available off-the-shelf.
Example 1: A patient with lower back pain caused by muscle strain or sprain may use this orthosis to provide support, limit movement, and relieve pain., Following a lumbar disc herniation, a patient could use this brace to stabilize the spine and reduce pressure on the affected disc during healing., Individuals with a pendulous abdomen may benefit from the added support offered by the optional design of this orthosis.
Documentation should include the diagnosis justifying the need for the orthosis, such as lower back pain, lumbar disc herniation, or other relevant condition, as well as any specific features required (e.g., pendulous abdomen design). Records must also specify that it is prefabricated and off-the-shelf.
- Specialties:Orthopedics, Physical Medicine and Rehabilitation, Pain Management
- Place of Service:Office, Outpatient Hospital, Home