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Passport LSO (60-3210-3)

Item #: 50R215N
Premium LSO (T9-S1)
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Suggested HCPCS Coding: L0631 Custom Fit / L0648 OTS

PDAC Verified
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Overview

LSO offers 5:1 compression and stabilization from T9 to S1.

Features

  • Unsurpassed compression and support with a 5:1 mechanical advantage pulley system
  • One-hand pull system compresses and cones to individual patient anatomy
  • Low-profile corset and panels for increased patient compliance
  • Modular step-down system is ideal for treatment pre-op, post-op, and through rehabilitation
  • Mesh corset and breathable anterior and posterior panels for increased patient comfort

Indications

  • Indicated for degenerative and bulging discs, lumbar sacral mechanical back pain, Spinal Stenosis, Spondylolisthesis, Facet Syndrome, herniated/bulging discs, post-operative stabilization protocol following Laminotomy, Foraminotomy, IDET proceedures, anterior laproscopic fusion, posterior lateral fusion, and multi-level decompression.

Specifications

Measure waist circumference.
Size Waist Circumference Part Number
S 25"-30" (63.5-76cm) 50R215N=1
M 30"-35" (76-89cm) 50R215N=2
L 35"-40" (89-101.5cm) 50R215N=3
XL 40"-45" (101.5-114.5cm) 50R215N=4
XXL 45"-50" (114.5-127cm) 50R215N=5
XXXL 50"-55" (127-139.5cm) 50R215N=6

Documents

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PDAC Letter

Reimbursement: PDAC

Reimbursement

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