February 2020

CMS Adds New L-Code for 2020; Updates Therapeutic Shoe Modification Codes

The Centers for Medicare & Medicaid Services (CMS) have announced the following updates, which are effective for dates of service on or after January 1, 2020:

New L-Code: A new lower extremity–related Healthcare Common Procedure Coding System (HCPCS) code has been added. The new code is L2006: Knee ankle foot device, any material, single or double upright, swing and/or stance phase microprocessor control with adjustability, includes all components (eg, sensors, batteries, charger), any type activation. To access the complete list of 2020 codes, additions, deletions, and changes, visit cms.gov/Medicare/Coding/HCPCSReleaseCodeSets/Alpha-Numeric-HCPCS.

Fee Schedule Change, Therapeutic Shoe Modifications: Fee schedule amounts have been adjusted for shoe modification codes A5503 through A5507 to reflect more current allowed service data. Section 1833(o)(2)(C) of the Social Security Act required that the payment amounts for shoe modification codes A5503 through A5507 be established in a manner that prevented a net increase in expenditures when substituting these items for therapeutic shoe insert codes (A5512 or A5513). Base fees for A5512 and A5513 were weighted based on the approximated total allowed services for each code for items furnished during the second quarter of 2004 to establish the fee schedule amounts for the shoe modification codes. For 2020, CMS weights the base fees for A5512 and A5513 based on the approximated total allowed services for each code for items furnished during 2018. To access the 2020 fee schedule, visit: https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/DMEPOSFeeSched/DMEPOS-Fee-Schedule.

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