2025 HCPCS code L0651

Supply of a prefabricated lumbosacral orthosis (LSO) with sagittal and coronal control, rigid shell(s), and features designed to reduce spinal load.

Appropriate coding requires correct selection of the LSO based on the patient's specific needs and condition.Ensure that fitting and adjustment services are not billed separately.

Modifiers may apply depending on circumstances; refer to the HCPCS modifier guidelines for details. Modifiers such as those indicating purchase (AV), rental (BR), or lease (LL) could be relevant.

Medical necessity for L0651 is established when the patient presents with a condition requiring support, stabilization, and/or pain relief for the lumbosacral spine.This would be documented in the patient's medical record through clinical findings, diagnostic testing, and treatment plan.

The clinical responsibility involves assessing the patient's condition, determining the need for an LSO, selecting the appropriate size and type of LSO, fitting the brace, and educating the patient on proper use and care.

IMPORTANT For other lumbar orthoses with sagittal coronal control, see codes L0633 to L0640 and L0649 to L0650. For lumbar orthoses with sagittal control, see codes L0626 to L0623 and L0641 to L0648.

In simple words: This code covers a ready-made back brace that helps support the lower back and limit movement. It's designed to ease back pain by taking pressure off the spinal discs.The brace is custom-fit and includes straps and closures.

This HCPCS code, L0651, represents the supply of a prefabricated lumbosacral orthosis (LSO).This rigid LSO provides sagittal and coronal plane movement restriction.The posterior panel extends from the sacrococcygeal junction to the T9 vertebra, while the anterior panel extends from the symphysis pubis to the xyphoid process. The design incorporates intracavitary pressure to reduce load on the intervertebral discs.Overall strength is achieved through overlapping rigid material and stabilizing closures, including straps. It may include a soft interface and a pendulous abdomen design. The orthosis is prefabricated and available off-the-shelf.Fitting and adjustments are included in this code and should not be billed separately.

Example 1: A patient presents with chronic low back pain due to degenerative disc disease.The physician orders a prefabricated LSO (L0651) to provide support and reduce pain., A patient recovering from a lumbar spine injury requires additional support during ambulation and daily activities. The physical therapist recommends a prefabricated LSO (L0651) to enhance stability and facilitate rehabilitation., A patient with spinal stenosis experiences increased pain and instability during activities. The physician prescribes a prefabricated LSO (L0651) to improve spinal alignment and alleviate symptoms.

Physician's order specifying the need for an LSO, including the type, size, and any specific requirements.Patient's medical history, physical examination findings documenting the need for the LSO, and imaging studies (if applicable) confirming the diagnosis.Documentation of the fitting and adjustment of the LSO.

** This code includes the fitting and adjustment of the orthosis.The description details specific design features; ensure the supplied orthosis meets these criteria for accurate coding.

  • Payment Status: Active
  • Specialties:Orthopedics, Physical Medicine and Rehabilitation, Neurosurgery
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
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