The Centers for Medicare and Medicaid Services (CMS) has released its 2010 fee schedule for durable medical equipment, prosthetics, orthotics, and supplies and listed the Healthcare Common Procedure Coding System (HCPCS) codes to be deleted and added in 2010. The changes will be effective on January 1 and implemented on January 4.
Codes
The following HCPCS codes will be deleted:
- L-1825: Knee orthosis, elastic knee cap, prefabricated, includes fitting and adjustment
- L-3701: EO, elastic, prefabricated, includes fitting and adjustment (E.G., neoprene, lycra)
- L-1901: Ankle orthosis, elastic, prefabricated, includes fitting and adjustment (E.G., neoprene, lycra)
- L-3909: Wrist orthosis, elastic, prefabricated, includes fitting and adjustment (E.G., neoprene, lycra)
- L-2770: Addition to lower-extremity orthosis, any material – per bar or joint (E.G., neoprene, lycra)
- L-3911: Wrist hand finger orthosis, elastic, prefabricated, includes fitting and adjustment (E.G., neoprene, lycra)
- L-0210: Thoracic, Rib Belt (E.G., neoprene, lycra)
- L-3651: SO, single shoulder, elastic, prefabricated, includes fitting and adjustment (E.G., neoprene, lycra)
- L-6639: Upper extremity addition, heavy duty feature, any elbow
- L-1800: Knee orthosis, elastic with stays, prefabricated, includes fitting and adjustment
- L-3652: SO, double shoulder, elastic, prefabricated, includes fitting and adjustment (E.G., neoprene, lycra)
- L-1815: Knee orthosis, elastic or other elastic type material with condylar pad(s), prefabricated, includes fitting and adjustment
- L-3700: EO, elastic with stays, prefabricated, includes fitting and adjustment
- E-2393: Power wheelchair accessory, valve for pneumatic tire tube, any type, replacement only, each
- A-4365: Adhesive remover wipes, any type, per 50
The following new O&P codes covered by Medicare will be added:
- L-5973: Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source
- L-8031: Breast prosthesis, silicone or equal, with integral adhesive
- L-8032: Nipple prosthesis, reusable, any type, each
- L-8627: Cochlear implant, external speech processor, component, replacement
- L-8628: Cochlear implant, external controller component, replacement
- L-8629: Transmitting coil and cable, integrated, for use with cochlear implant device, replacement
- Q-0506: Battery, lithium-ion, for use with electric or electric/pneumatic ventricular assist device, replacement only
Fees
Due to the shrinking U.S. economy, CMS will not raise fees in 2010. CMS explained in its MLN Matters article MM6720 that the DMEPOS fee schedule amounts are calculated according to the percentage increase in the consumer price index for all urban consumers (CPI-U) for the 12-month period ending in June 2009. Since the CPI-U for this period dropped by 1.41 percent, there will be no fee schedule increase for 2010. Labor payments, being based on the Consumer Price Index (CPI) for the 12-month period ending with June of the previous year, will also not increase, since CPI dropped as well.
To view the complete list of new L-Codes for 2010, visit http://www.cignagovernmentservices.com/jc/pubs/news/2009/1209/cope11134.html
To view and download the DMEPOS fee schedule, visit link www.cms.hhs.gov/DMEPOSFeeSched/
