HCPCS: L0639 or L0651
HCPCS review letter on file.
LSO Body Jacket with APL Control. Provides moderate to firm support, combining the strength of a rigid spinal brace with the comfort of a lumbosacral support garment. 1/16" Polyethylene jacket is preformed, lined and can be easily modified with a heat gun or scissors. Two front Polyethylene sliding panels simplify modification and adjustments and has three hook 'n pile cinch strap closures per side. Brace is very lightweight and easily cleaned. Indications for use include compression fracture; chronic back pain; degenerative, herniated or bulging disc; spinal stabilization; spondylolysis; spondylolisthesis.
Sizing Chart
| Size | Hip
Circumference | Height |
| Small | 28"-32" | 10¼" |
| Medium | 33"-37" | 11" |
| Large | 38"-42" | 11¾" |
| X-Large | 42"-50" | 11¾" |
| 2X-Large | 50"-58" | 11¾" |
Available Options:
Size:
Back Care