Elastic Back Brace with Rigid Removable Tall Back Panel
Suggested HCPCS Code: L0631/L0648
- Lightweight low-profile design
- Removable 14″ posterior panel for exact comfort
- Elastic compression pulls for support where needed
- Breathable mesh fabric
| Product Number | Size | Waist Size |
| 12-0200 | X-Small | 26″-32″ |
| 12-0201 | Small | 32″-36″ |
| 12-0202 | Medium | 36″-40″ |
| 12-0203 | Large | 40″-44″ |
| 12-0204 | X-Large | 44″-48″ |
| 12-0205 | 2X-Large | 48″-52″ |
| 12-0206 | 3X-Large | 52″-58″ |
| 12-0207 | 3X-Large | 58″-64″ |
Underlying Conditions:
- Osteoarthritis
- Spinal Stenosis
- Intervertebral Disc Disorders
- Sprain of Spine and/or Pelvis
- Radiculopathy
- Spondylosis
Coverage Criteria:
(Patient must meet one of the following criteria)
- Reduce pain by restricting mobility of trunk
- Help heal injury to spine or related soft tissue
- Help heal post-surgery to spine or related soft tissue
- Supporting weak spinal muscles and/or deformed spine
Our Process is as follows:
- 1. Choose a brace, send a brace request form and a facesheet to our office.
- 2. PME will verify insurance coverage, prepare a script and send it to the requester for a DR signature.
- 3. Facility sends back signed script
- 4. PME ships brace to the facility.
