October 2014

CMS adds two OTS knee orthosis codes

The Centers for Medicare and  Medicaid Services (CMS) made effective on October 1 two new off-the-shelf (OTS) knee orthosis codes.

These are K0901, for a knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus and valgus adjustment, prefabricated, and OTS, and K0902, for a knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus and valgus adjustment, prefabricated, and OTS.

The codes are OTS versions of L1843 and L1845, respectively, and join the 23 other OTS codes that CMS established as part of the 2014 Healthcare Common Procedure Coding System (HCPCS) update. This means that if a product currently coded L1843 or L1845 requires only minimal self-adjustment for fitting at the time of the delivery, these new OTS “K” codes are the ones that should be billed.

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