The Centers for Medicare & Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS) public meeting agenda, which includes CMS’ preliminary coding decision, for durable medical equipment, orthotics, prosthetics, and supplies (DMEPOS) has been released. The meeting, slated for June 3, will be held at the CMS Auditorium, 7500 Security Boulevard, Baltimore (Woodlawn), Maryland 21244-1850.
The following list details agenda items that pertain to O&P. Applicants will be notified of final decisions in November.
- Request to establish a new level II HCPCS add-on code to identify certified water resistance of an electrical terminal device (ETD).
- Request to establish a new level II HCPCS code to identify a custom-fabricated metacarpal or partial hand external-powered prosthesis that includes attachment points for fingers, but does not include fingers or other terminal device.
- Request to revise existing level II HCPCS codes L-7260 (Electronic wrist rotator, Otto Bock or equal) and L-7261 (Electronic Wrist Rotator, for Utah Arm) to omit product brand names and to specify the type of control mechanism employed.
- Request to either revise existing level II HCPCS codes L-6250 (Elbow inter loc elbow forarm), L-6300 (Shldr disart int lock elbow), L-6350 (Thoracic intern lock elbow), L-6950 (Above elbow switch control), and L-6955 (Above elbow myoelectric control) to specify “with or without” internal locking elbow, and revise existing codes L-6960 (Shldr disartic switch control), L-6965 (Shldr disartic myoelectric control), L-6970 (Interscapular-Thor switch control), and L-6975 (Interscap-Thor myoelectronic control) to specify mechanical “or friction” elbow; or create nine parallel new codes, substituting the term “friction elbow” for “internal locking elbow” and “mechanical elbow,” to identify a multipositional friction prosthetic elbow with forearm, trade name 12K12 MovolinoArm Friction, Ottobock, Duderstadt, Germany.
- Second request to establish a new level II HCPCS base code to identify an “Energy Storing AFO, posterior leaf spring design, custom-fabricated of a composite material to produce a specific loading and return of energy that quantitatively matches the plantar flexor deficits of the patient,” trade name: Dynamic Response AFO. Applicant’s suggested language: “Energy Storing AFO, Custom Engineered and Fabricated to Match the Patient’s Deficit, Utilizing FFA Protocols For Composite Fabrication.”
- Request to establish a new level II HCPCS code to identify a microprocessor-controlled ankle-foot system, trade name: elán, Endolite, Miamisburg, Ohio. Applicant’s suggested language: Endoskeletal ankle foot system, microprocessor-controlled feature, independent variable energy storage and hydraulic stance control, independent plantar flexion and dorsiflexion dampening with automatic terrain response includes sensors and power source.
- Request to establish a new level II HCPCS code to identify a fracture reduction orthosis, trade name: Bledsoe PHX Fracture Reduction Orthosis. Applicant’s suggested language: L-XXXX, Elbow orthosis, with fracture-reduction hinge(s), with adjustable elbow position locking joints(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise.
