The Centers for Medicare & Medicaid Services (CMS) has released MLN Matters Change Request CR 8325 to announce the July quarterly update for the 2013 durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) fee schedule. The DMEPOS fee schedules are updated on a quarterly basis, when necessary, in order to implement fee schedule amounts for new and existing codes, as applicable and to apply changes in payment policies.
Specific to O&P, CR 8325 updates the fee for L-5859 (addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)). This code was added to the Healthcare Common Procedure Coding System (HCPCS) file effective January 1, 2013. Previously these items were paid on a local fee schedule. If claims for these codes with dates of service on or after January 1, 2013, have already been processed, they will be adjusted to reflect the new fees if the provider brings the claims to its contractor’s attention.
To read the official instruction regarding this change, visit the CMS website.