Spinal orthoses — TLSO & LSO bracing
From flexible off-the-shelf trunk support to rigid sagittal-coronal shells. We carry the Trend line across the range — and we track which codes need prior authorization and a Written Order Prior to Delivery, so your order doesn't stall.
Trunk and lumbar-sacral support, by indication
A spinal orthosis is a brace that supports the thoracic, lumbar, or sacral spine — used for conditions like post-surgical stabilization, compression fractures, and degenerative disease. The right device depends on the levels involved and how much rigidity the clinician wants: a flexible thoraco-lumbo-sacral wrap (TLSO) is a different order from a rigid lumbar-sacral shell (LSO).
All of these codes are governed by Local Coverage Determination L33790 (Spinal Orthoses: TLSO and LSO). Importantly, the rigid lumbar-sacral codes L0648, L0650, and L0651 are on the Medicare Required Prior Authorization List and require a Written Order Prior to Delivery — and L0651's prior-authorization requirement is new, effective April 13, 2026 (CMS-6097-N). We handle the prior-authorization submission and won't deliver until there's an affirmative decision and the WOPD is in hand.
Codes, products & requirements
The full range we carry, with prior-authorization and WOPD status by code:
| HCPCS | Trend product | Description | Prior auth | WOPD |
|---|---|---|---|---|
L0457 |
Trend Correx TLSO (DCT-5657) | TLSO, flexible, provides trunk support, sagittal-coronal control via rigid panels — prefabricated, off-the-shelf (OTS) | No | No |
L0464 |
Trend Correx SP TLSO (DCT-0464) | TLSO, sagittal-coronal control, rigid posterior frame and four rigid panels, sacro-scapular — prefabricated, OTS | No | No |
L0648 |
Trend LSO (DCT-31) | LSO, sagittal control, rigid anterior and posterior panels — prefabricated, OTS | Yes — since 2022-04-13 | Yes |
L0650 |
Trend Pro LSO (DCT-37) | LSO, sagittal-coronal control, rigid anterior and posterior panels — prefabricated, OTS | Yes — since 2022-04-13 | Yes |
L0651 |
Trend Extend LSO (DCT-3951) | LSO, sagittal-coronal control, rigid shell and panel design — prefabricated, OTS | Yes — effective 2026-04-13 | Yes |
L0651 changed in 2026. Effective 2026-04-13 (CMS-6097-N, 91 FR 1250), L0651 was added to the Required Prior Authorization List. Orders for L0651 now follow the same prior-authorization-then-WOPD path as L0648 and L0650. Our order forms were updated for this.
What "WOPD" means in practice: for L0648 / L0650 / L0651 we must have the complete, signed written order before the brace is delivered — not after. Get the order to us first and there's no delay; deliver-then-document isn't an option for these codes.
How to order a spinal orthosis
Spinal Bracing Standard Written Order
Fillable PDF · 35 KB · covers the full Trend line: L0457, L0464, L0648, L0650, L0651 · captures diagnosis ICD-10 codes, the practitioner-attestation language CMS expects, and explicit PA + WOPD reminders for the codes that need them · every field on this form is fillable in any PDF reader.
For L0648 / L0650 / L0651: the completed Written Order must reach us before we deliver the brace (WOPD requirement). Send the signed form first; we'll open the prior authorization and stage the device for fulfillment once it clears.
Pick the code
Choose by indication and rigidity — TLSO vs. LSO, flexible vs. rigid, the levels involved. Not sure which Trend product maps to your intended code? Call us.
Complete the SWO
Open the order form above, fill in patient/prescriber/diagnosis sections, mark the HCPCS, and have the treating practitioner sign. Face-to-face must be within the prior six months.
We open the prior auth
For codes that require it (L0648 / L0650 / L0651), we submit the prior-authorization request and don't furnish the device until there's an affirmative decision.
Fit, deliver & archive
We fit the brace to the patient, deliver it, and archive the order and supporting documentation — indexed by NPI and date.
Requirement questions? Ask the coverage assistant — e.g. "which Trend back braces need a WOPD?" or "what's the difference between L0648, L0650 and L0651?" Answers cite the governing LCD or federal rule. General reference only — not a coverage guarantee, and not for patient details.
Send a spinal-orthosis order
Fax a completed SWO (and WOPD where required) to 509-980-7062 or call us — we'll handle prior authorization and fitting.