The medical review staff at CGS will be conducting a complex post-pay service-specific medical review of two knee orthosis Healthcare Common Procedure Coding System (HCPCS) codes, L-1833 and L-1851, in Jurisdiction C.
The review is being conducted because data analysis revealed that Jurisdiction C’s allowed dollars for L-1833 and L-1851 were significantly above expected amounts. Additionally, CGS said the knee orthosis policy group ranked first in total Comprehensive Error Rate Testing Program errors.