Summary & Overview
HCPCS L2622: Lower-Extremity Pelvic Control Hip Joint, Adjustable Flexion
HCPCS Level II code L2622 denotes an addition to a lower-extremity orthosis that provides pelvic control at the hip joint with adjustable flexion, billed per each component. This orthotic add-on is relevant for patients requiring enhanced hip and pelvic stability as part of lower-extremity bracing strategies. Nationally, L2622 matters to clinicians, orthotists, suppliers, and payers because it specifies reimbursement classification for a distinct adjustable hip joint component of orthoses, affecting coverage determinations and claim processing.
Key payers included in this overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code and its clinical application, typical sites of service, and what to expect in payer coverage discussions. The publication also summarizes common modifiers and claims-level considerations, benchmarks where available, and policy updates or coding guidance when supplied. Clinical context covers indications for use and the role of an adjustable hip joint in managing pelvic control in patients using lower-extremity orthoses. If specific payer policy details, associated taxonomies, ICD-10 pairings, or related codes are not provided in the input, those fields are noted as not available.
Billing Code Overview
HCPCS Level II code L2622 describes an addition to lower extremity pelvic control at the hip joint with adjustable flexion, billed per each addition. The service type is an orthotic component intended to provide pelvic and hip support and allow adjustable flexion settings for lower-extremity orthoses. The typical site of service is outpatient durable medical equipment (DME) supply or an orthotics/prosthetics clinic, where the component is fitted or added to an existing lower-extremity orthosis.
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Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with pelvic instability or hip joint deformity requiring enhanced lower‑extremity and pelvic control as part of a custom or prefabricated hip‑knee‑ankle orthosis (HKAFO) or accompanying orthotic system. The patient often has neuromuscular weakness, spasticity, hip subluxation, or post‑operative hip instability following total hip arthroplasty, pelvic fracture repair, or reconstructive hip surgery. The orthotist evaluates range of motion, pelvic alignment, and hip joint stability, and documents functional deficits (gait deviation, recurrent hip dislocation, inability to ambulate safely).
A prescription from an authorized clinician (physiatrist, orthopedic surgeon, or rehabilitation specialist) specifies an orthotic addition for the lower extremity and pelvic control with an adjustable hip flexion joint. The orthotist fabricates or adapts the device, fits the patient, and adjusts the device (including adjustable flexion stops). The clinical workflow includes: initial evaluation with objective measures, trial fitting, fitting and adjustment visit(s), patient education on donning/doffing, and follow‑up for device tuning and potential repair or replacement. Documentation includes the medical necessity rationale, device description referencing L2622, measurable functional limitations, and time/date of fitting and adjustments.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT |