Universal Elastic Lumbosacral Wraparound
[E1191]

HCPCS: L0625
Modifier: GY (elastic)
HCPCS review letter on file.

Economy Universal Elastic Lumbosacral Wraparound Support. Adjustable hook 'n pile front closure with separate 3" wide belt secured in back for added sizing and tension adjustment. Firm elastic back is attached to soft lightweight flannel lined sides and front. Other features include two flexible stays and two spiral stays. One size fits hips: 30"-50".

Front height: 5"
Back height: 9"