The Centers for Medicare and Medicaid Services (CMS) has released the new Healthcare Common Procedure Coding System (HCPCS) codes, which will be effective for claims with a date of service on or after January 1, 2017. Below is a breakdown of the O&P-related code changes, as reported by the American Orthotic & Prosthetic Association (AOPA). AOPA said its Coding and Reimbursement Committee will review the list of changes and provide appropriate comments to CMS.
New Codes
A-4467: Belt, strap, sleeve, garment, or covering, any type
A-9285: Inversion/eversion correction device
L-1851*: Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
L-1852*: Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Changes in Code Descriptors
L-1906, new descriptor: Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf
L-1906, old descriptor: AFO, multiligamentous ankle support, prefabricated, off-the-shelf
Deleted Codes
A-4466: Garment, belt, sleeve or other covering, elastic or similar stretchable material, any type, each
K-0901*: Knee orthosis (KO), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
K-0902*: Knee orthosis (KO), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
*Note: K-0901 and K-0902 were temporary codes that became effective on October 1, 2014, to describe off-the-shelf (OTS) versions of custom-fitted knee orthoses described by L-1843 (Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise) and L-1845 (Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise), and their subsequent crosswalk to new permanent L-Codes, L-1851 and L-1852.
