Thomas F. Fise, executive director of the American Orthotic & Prosthetic Association, recently released a formal letter to CMS listing 26 codes for orthoses that should be removed from its off-the-shelf list.
CMS is moving forward with the inclusion of these orthoses in advance of the announcement of new Healthcare Common Procedure Coding System codes on or before Nov. 27. The new codes will be effective Jan. 1, 2014.
According to the letter, the 26 codes slated for the off-the-shelf (OTS) list should be recognized (1) as virtually always requiring clinical care and (2) as not meeting the terms of the statutory definition for OTS devices, ie, not being capable of being used by the patient with “minimal self-adjustment.”
The codes include: L0172, L0174, L0456, L0466, L0468, L0623, L0625, L0626, L0627, L0628, L0630, L0631, L0633, L0637, L0639, L1810, L1832, L1850, L3670, L3675, L3807, L3915, L3923, L4360, L4386 and L4396.
To view the letter, click here.