Spinal Orthoses: TLSO and LSO
National · Effective Jan 1, 2020
1 active Medicare policy lists L0639, and 4 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
Free account. Policy pages stay open to everyone.
National · Effective Jan 1, 2020
4 policies from 4 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of L0639 |
|---|---|---|
| Durable Medical Equipment and Orthotics and Prosthetics Guidelines | Not recorded | Covered |
| Policy | Effective | Status of L0639 |
|---|---|---|
| CG-OR-PR-06 Spinal Orthoses: Thoracic-Lumbar-Sacral (TLSO), Lumbar-Sacral (LSO), and Lumbar | Oct 1, 2025 | Covered |
| Policy | Effective | Status of L0639 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List - Effective 01/01/2025 | Jan 1, 2025 | Prior auth required |
| Policy | Effective | Status of L0639 |
|---|---|---|
| Spinal Orthoses: Thoracic-Lumbar-Sacral (TLSO), Lumbar-Sacral (LSO), and Lumbar | Jul 1, 2026 | Covered |