HCPCS Code L0621: Sacroiliac Orthosis (Flexible, Prefabricated, Off-the-Shelf)

A clear HCPCS code narrative and long code narrative help ensure that the code selected for an orthosis or device accurately reflects its purpose, construction, and use for the specific patient. This process assists providers in meeting coding verification and written coding verification review requirements, while also aligning with the statutory definition outlined in the Social Security Act.

Coding verification and meeting Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) quality standards confirm that the orthosis is designed to stabilize the sacroiliac joint, reduce excessive motion, and support pelvic-sacral alignment. When the orthoses coded match the criteria applicable, suppliers are better protected during audits and ensure compliance with applicable federal regulations and the Medicare braces benefit.

The differentiating factor often lies in whether the device requires specialized training to fit or allows for minimal self-adjustment. Off-the-shelf orthoses (L0621) can be used with little-to-no modification beyond basic fitting and can even be done by the patient, while custom-fitted orthoses (L0625) require trimming, molding, or other adjustments by a trained professional to achieve a proper individualized fit.