HCPCS: L0631 or L0648
HCPCS review letter on file.
Unisex OrthoLux LSO with Rigid Anterior, Posterior & Lateral Panels. This soft, tri-laminate fabric is breathable, moisture wicking and features four pockets containing rigid molded polymer panels. Completely modular, each piece is separately attached by hook and loop panels.
MODEL 955NT15
Front: NT = neutral front, Back: 15 = 15 degrees lordosis.
(Other options available on special order basis only.)
See front & back height chart and size chart below.
OrthoLux Front & Back Height Chart
| Size | Front Height | Back Height |
| Fabric | Insert | Fabric | Insert |
| Small |
9-1/2" |
8-1/8" |
14-1/4" |
13-3/8" |
| Medium |
10-3/8" | 8" |
15-3/4" |
13-1/2" |
| Large |
10-1/2" |
8-1/4" | 16" |
13-5/8" |
| X-Large |
11-3/8" |
8-1/2" | 16" |
13-3/4" |
| 2X-Large |
11-3/8" |
8-1/2" | 18" |
15-5/8" |
| 3X-Large |
11-5/8" |
8-1/2" | 18" |
15-5/8" |
| 4X-Large |
11-5/8" |
8-1/2" | 18" |
15-5/8" |
OrthoLux Size Chart
| Size | Circumference |
| Hip | Waist | Rib |
| Small | 29"-35" | 28"-34" | 28"-34" |
| Medium | 32"-39" | 30"-37" | 30"-36" |
| Large | 36"-42" | 34"-42" | 34"-40" |
| X-Large | 39"-47" | 38"-45" | 38"-45" |
| 2X-Large | 45"-52" | 43"-51" | 43"-51" |
| 3X-Large | 51"-56" | 47"-55" | 47"-55" |
| 4X-Large | 57"-63" | 53"-61" | 53"-61" |
Available Options:
Size:
Back Care