On November 15, Thomas F. Fise, executive director of the American Orthotic & Prosthetic Association (AOPA) formally petitioned the Centers for Medicare & Medicaid Services (CMS) to remove certain orthotics from its off-the-shelf (OTS) list. According to the letter Fise sent, the 26 Healthcare Common Procedure Coding System (HCPCS) codes that AOPA specifically cited virtually always require clinical care and do not meet the terms of the statutory definition for OTS devices in that they are not capable of being used by the patient “with minimal self-adjustment.”
The affected codes are: L-0172, L-0174, L-0466, L-0468, L-0623, L-0625-L-0628, L-0630, L-0631, L-0633, L-0637, L-0639, L-1810, L-1832, L-1850, L-3670, L-3675, L-3807, L-3915, L-3923, L-4360, L-4386, and L-4396.
