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CMS Issues Temporary K-Code for Direct-milled Diabetic Inserts

by The O&P EDGE
January 23, 2018
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The Centers for Medicare & Medicaid Services (CMS) has issued a temporary Healthcare Common Procedure Coding System (HCPCS) code to describe direct-milled, custom fabricated diabetic inserts.

Effective April 1, the new code, K-0903, reads: For diabetics only, multiple density insert, made by direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient, total contact with patient’s foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each.

The temporary code will allow CMS to track utilization prior to deciding whether to issue a permanent HCPCS code. The code differentiates between custom-fabricated diabetic inserts that are molded over a physical model of the patient’s foot (A-5513) from those that are direct milled based on a digital or virtual model of the patient’s foot.

A fee schedule for K-0903 has not been released.

Related posts:

  1. Let Me Be Direct: A-5513 Coding Clarification & The Future of CAD/CAM Direct-milled Inserts
  2. New Medicare Rules Take Effect for O&P Care
  3. DME MACs Release Partial Foot, Shoe Insert Coding Clarification
  4. CMS Sets Fee Restructure for Custom-fabricated, Direct-milled Diabetic Inserts
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