Thursday, April 18, 2024

AFO/KAFO LCD Response

Paula Rogerson-Doherty

Hello All,

Good news, Noridian has clarified that the language applies to NOC codes.

Below is the communication I received back from the Medical Director at Noridian (Wilfred Mamuya, MD,PhD) regarding the information they previously provided and the concerns with revision to the LCD revision.

Paula,

Thanks for sharing your concerns with us.

The DME MACs have jointly discussed your concerns, which were also raised by one other supplier.

We believe the confusion exists with the migration of the miscellaneous code documentation requirements to the Standard Documentation Requirements (SDR) Policy Article. The NOC information simply moved to the Standard Documentation Article because that information applies to all NOC codes.

There has been no change in the documentation requirements for either miscellaneous codes (NOC) or the information requested for custom fabricated codes. For custom fabricated products that do not have specific HCPCS codes, the supplier needs to provide a complete and clear description of the item, including what makes this item unique, and a breakdown of charges (material and labor used in fabrication). This information should be entered in the narrative field of an electronic claim.

We will clarify in an upcoming revision to the AFO/KAFO Policy article.

Best,

Fred

Paula Rogerson-Doherty
Business & Administrative Manager
Rogerson Orthotics & Prosthetics
P: (617) 268-1135
F: (617)269-3373
https://urldefense.proofpoint.com/v2/url?u=http-3A__www.rogersonoandp.com&d=DwIFAg&c=sJ6xIWYx-zLMB3EPkvcnVg&r=KmuawjwNpT9A2bnhzaNVjw8wO7L_TDosEXIk33h_tlw&m=wRfVeI4mBQwjZfzbmKck9oHIT89lEaghUYxHnl-M1Vg&s=BXgUaX9NcuTPTCR2KBmxSOtep3y1cC9QKxN_E4DW3lM&e=

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