Elastic Sacroiliac Wraparound w/Sacral Pad
[970]

HCPCS: L0621
Modifier: GY (elastic)
HCPCS review letter on file.

Elastic Sacroiliac Wraparound. One-way stretch contoured elastic with hook 'n pile closure and removable sacral pad. Flexible oblique stays front and back. Sized according to hip measurement.

Note: For replacement sacral pad, order Model 9570.

Front height: 5-1/2"
Back height: 8"

Sizes:
S (30"-33")
M (34"-37")
L (38"-41")
XL (42"-45")
2XL (46"-50")