PDAC CODE APPROVAL = L0457
AlignMed has received formal approval from the Centers of Medicare & Medicaid Services (CMS) through the Pricing, Data Analysis and Coding (PDAC) for the HCPCS Billing code of L0457. In lay terms this means our SQ is now eligible for Medicare and Medical reimbursement, and that means millions of people will now be able to acquire this miraculous product. AlignMed is extremely proud to announce the great news that's culminated in ten years of diligent hard work, and that further serves to validate our mission.
The AlignMed SpinalQ™ is a revolutionary product, so much so that we believe it to be the very best product of its kind in the world. Having this highest level of validation just reinforces our position. Our SpinalQ™ is engineered for maximum support and protection while delivering the world's most comfortable wearing experience. Our patient compliance exceeds industry averages by the widest of margins, and that means efficacy and results for our customers, that exceeds all others. The major afflictions of Thoracic Outlet Syndrome and other conditions such as osteoporosis, in addition to the routine yet severe back and shoulder problems are well treated with our SpinalQ™. This product has proven to be the only dynamic Shoulder rehabilitation device that addresses Scapular dysfunction in conjunction with the thoracic spine, and is widely accepted as the standard of care for shoulder pre-hab and rehab.
HCPCS Code: L0457
Short Description: TLSO= Thoracic Lumbar Sacral Orthosis, FLEXIBLE, PROVIDES TRUNK SUPPORT, INCLUDES STRAPS AND CLOSURES, PREFABRICATED, OFF-THE-SHELF
The Fee Schedule for L0457 varies by geographical state, but the approximate reimbursement according to the Medicare Fee Schedule is approximately $915 - $944. https://www.dmepdac.com/dmecsapp/do/feesearch?scheduleeffectivedate=01%2F01%2F2014&hcpcsCode=L0457&hcpcskeyword=
This code is an excellent fit for the AlignMed SpinalQ™ Brace (Model # S3-SQ456), as we believe it is a unique and effective dynamic training device for a multitude of pathologies related to the Spine, Shoulder, and overall Posture. Our proprietary use of NeuroBands™ in conjunction with our Patented Scapular Retractor Straps are now formally recognized by Medicare and other Insurance companies as a valid modality of treatment for various pathologies.
To ensure coverage, Medicare states:
A thoracic-lumbar-sacral orthosis (L0450-L0492) is covered when it is ordered for one of the following indications:
1. To reduce pain by restricting mobility of the trunk;
2. To facilitate healing following an injury to the spine or related soft tissues.
3. To facilitate healing following a surgical procedure on the spine or related soft tissue.
4. To otherwise support weak Spinal muscles and/or a deformed spine.
If a Spinal Orthosis is provided and the coverage criteria are not met, the item will be denied as not medically necessary.
AlignMed has put 10 years of diligent work combined with scientific research to create the most revolutionary product on the market. Over 100,000 customers, physicians, and distributors have provided us with excellent feedback and now that Medicare has approved us for the HCPCS Billing code of L0457 we will be able to help so many more people who need a rigid orthosis that can also be used as a dynamic support system for Muscle retraining and biofeedback
Bob Waeger | Medical Sales Director
2909 Tech Center Drive, Santa Ana, CA 92705
T 714-975-9330 C 714-514-8038
bwaeger@alignmed.com alignmed.com
