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DME MACs Announce Spinal Orthosis L-0430 Invalid

by The O&P EDGE
January 18, 2013
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The Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have announced that Healthcare Common Procedure Coding System (HCPCS) code L-0430 (spinal orthosis, anterior-posterior-lateral control, with interface material, custom fitted (Dewall Posture Protector only)) is invalid, effective for dates of service on or after November 17, 2012.

Products previously coded L-0430 by the Pricing, Data Analysis, and Coding (PDAC) contractor and posted to the Durable Medical Equipment Coding System (DMECS) will be end dated on November 17, 2012.

Manufacturers, distributors, or suppliers that previously billed for L-0430 should submit a Coding Verification Review Application to the PDAC to determine the correct billing code. The PDAC coding verification review application required for these products is the orthotics application, which can be located on the PDAC website.

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