Summary & Overview
HCPCS L2624: Lower Extremity Addition for Pelvic and Hip Control, Adjustable Joint
HCPCS Level II code L2624 denotes an add-on component to a lower-extremity orthosis providing pelvic control and a hip joint with adjustable flexion, extension, and abduction control, reported per each component. This code is relevant nationally for providers and durable medical equipment (DME) suppliers that fit complex hip–pelvic–lower extremity orthoses for patients with gait instability, neuromuscular disorders, or significant pelvic/hip instability. Coverage and payment for this component affect access to tailored orthotic solutions that restore mobility and reduce secondary injury risk.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the code's clinical role, typical sites of service, and how the component is used in orthotic management. The publication outlines common payer considerations and benchmarking topics readers can expect, including coding context, reimbursement treatment across major payers, and policy or documentation elements that commonly influence coverage decisions. Data not available in the input for specific payer rates, associated taxonomies, ICD-10 pairing guidance, and related codes is noted where applicable in detailed sections.
Billing Code Overview
HCPCS Level II code L2624 describes an addition to a lower extremity orthotic that provides pelvic control and hip joint support with adjustable control for flexion, extension, and abduction, billed per each device component. The service type is orthotic device component/adjustment intended to augment a lower-extremity orthosis with hip and pelvic control features. The typical site of service is outpatient orthotics/prosthetics clinics, durable medical equipment providers, and institutional outpatient departments.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with a significant lower-extremity orthopedic impairment (for example, hip instability after fracture fixation, pelvic girdle weakness following pelvic fracture, or neuromuscular weakness from stroke) who requires an orthotic addition to improve pelvic and hip joint control. The patient presents to an orthotics and prosthetics clinic after referral from an orthopedic surgeon or physiatrist. Evaluation includes gait and functional mobility assessment, range of motion and strength testing, and review of prior imaging and surgical reports. The certified orthotist documents the clinical need for an adjustable flexion/extension/abduction control hip joint attachment to a lower-extremity orthosis, performs measurements, and fabricates or fits the L2624 component as an addition to the existing orthosis. Follow-up visits address component adjustments, functional training, and documentation of progress or complications. Typical sites of service include outpatient orthotics clinics, hospital-based prosthetics/orthotics departments, and inpatient rehabilitation units where custom orthoses are fitted and adjusted.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Applied when the L2624 addition is for the left lower extremity/pelvic/hip side |