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How To Order SpinalQ

Click HERE for a free no obligation insurance verification to determine if your insurance will cover the SpinalQ brace, if so follow the steps above once you hear from our insurance specialist.
 
Documents Needed To Order The Alignmed SpinalQ Brace Through Insurance:

 

1. Letter Of Medical Necessity or Prescription / Script:  

Download form
Please include height, weight, chest measurement or bra size.

 

2. Demographics / Face Sheet:

Patient's address, phone number, and date of birth.

 

3. Insurance Card:

Copy of the front and back of insurance card.

 

4. Medical Chart Notes / Progress Notes From The Doctor:

The progress notes need to support the prescription for the SpinalQ TLSO Brace.  They should include one of the following below: 

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. 

 

5. RFA :

Work comp only.

 

Click HERE for a free no obligation insurance verification to determine if your insurance will cover the SpinalQ brace, if so follow the steps above once you hear from our insurance specialist.