HCPCS: L0621
Modifier: GY (elastic)
HCPCS review letter on file.
Elastic Sacroiliac Wraparound. One-way stretch
elastic with hook 'n pile closure and removable sacral
pad enclosed in water-repellent pocket. Separate
adjustable elastic band provides added support.
Flexible stays in back. Sized according to hip
measurement.
Note: For replacement sacral pad, order Model 3080.
Front height: 4"
Back height: 6"
Sizes:
S (30"-33")
M (34"-37")
L (38"-41")
XL (42"-45")
Available Options:
Size:
Back Care