An AFOs or KAFO is custom-fabricated may be considered medically necessary for ambulatory individuals when the basic coverage criteria listed above andANY ONEof the following criteria are met: If a custom fabricated orthosis is provided butallof the coverage criteria above including the additional criteria for a custom fabricated orthosis are not met, the custom fabricated orthosis will be denied as not medically necessary. Primary construction is a single metal upright which has a pivoting attachment into a sole component attached to an orthopedic shoe. You, your employees and agents are authorized to use CPT only as contained in the following authorized materials of CMS internally within your organization within the United States for the sole use by yourself, employees and agents. Note: Please see the following related documents for additional information: CG-DME-19 . Refer to the CODING GUIDELINES section below for additional information.A foot pressure off-loading/supportive device (A9283) is denied as noncovered (no Medicare benefit), because it does not support a weak or deformed body member or restrict or eliminate motion in a diseased or injured part of the body.An inversion/eversion correction device (A9285) is denied as noncovered (no Medicare benefit), because it does not act as a brace; that is, it does not support a weak or deformed body member or restrict or eliminate motion in a diseased or injured part of the body.Socks (L2840, L2850) used in conjunction with orthoses are denied as noncovered (no Medicare benefit).Refer to the Orthopedic Footwear policy for information on coverage of shoes and related items which are an integral part of a brace.There is no separate payment if computer-aided design/computer-aided manufacturing (CAD/CAM) technology is used to fabricate an orthosis. Codes L4396 and L4397 are used for an ankle-foot orthosis which is worn when a beneficiary is non-ambulatory, or minimally ambulatory. This information must be available upon request.For custom fabricated orthoses (L1904, L1907, L1920, L1940, L1945, L1950, L1960, L1970, L1980, L1990, L2000, L2005, L2006, L2010, L2020, L2030, L2034, L2036, L2037, L2038, L2106, L2108, L2126, L2128, L4631), there must be detailed documentation in the treating practitioner's records to support the medical necessity of custom fabricated rather than a prefabricated orthosis as described in the Coverage Indications, Limitations, and/or Medical Necessity section of the related LCD. All rights reserved. Knee Ankle Foot Orthoses (KAFOs) are designed to provide support and proper joint alignment of the knee, foot and ankle, assist or substitute for muscle weakness and joint instability, and protect the lower limb. Items that are primarily constructed of elastic or other stretchable materials (e.g. An asterisk (*) indicates a required field. There must be documentation of an appropriate stretching program carried out by professional staff (in a nursing facility) or caregiver (at home). L1900 (ANKLE FOOT ORTHOSIS, SPRING WIRE, DORSIFLEXION ASSIST CALF BAND, CUSTOM FABRICATED) describes a custom fabricated AFO designed to control inversion, eversion, dorsiflexion, and plantarflexion motions of the ankle foot complex. Revision Effective Date: 01/01/2017CODING GUIDELINES:Revised: Code pairs to accurately reflect parallel codesUpdated: HCPCS code narratives to align with HCPCS code tableAdded: Walking boot add-on bundling information. C-Brace is the world's first mechatronic stance and swing phase control orthosis (SSCO) system, which controls both the stance and swing phase hydraulically with microprocessor sensor technology. damages arising out of the use of such information, product, or process. Claims for add-on codes used with walking boots coded L4360, L4361, L4386 or L4387 will be denied as unbundling. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. All Rights Reserved (or such other date of publication of CPT). Code A4467 is denied as noncovered (no Medicare benefit). While there are several common indications for such an Orthosis, muscle weakness and paralysis of the leg are the ones most frequently identified. The most common causes of muscle weakness include: Absence of a Bill Type does not guarantee that the It is a unique orthosis and one of the most challenging devices that a Certified Orthotist is called on to provide. Reg Vol 217). sis ( n-ang'kl-fut r-th'sis) An orthosis extending from the upper portion of the thigh, crossing the knee and ankle, and terminating at the toes; designed to control knee and ankle motion. Revision Effective Date: 02/01/2021NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES:Revised: Braces Benefit to braces benefit Revised: Coding Guidelines to CODING GUIDELINES Revised: Ankle-Foot Orthosis to ankle-foot orthosis Revised: CAD-CAM to computer-aided design/computer-aided manufacturing (CAD/CAM) GENERAL REQUIREMENTS: Revised: Coding Guidelines to CODING GUIDELINES Revised: off-the-self to OTS MODIFIERS: Revised: KX, GA, and GZ MODIFIERS: to GA, GZ, KX, LT and RT MODIFIERS: Added: Statement regarding use of RT and LT, with reference to CODING GUIDELINES section for additional informationCODING GUIDELINES: Revised: Language describing parallel code set availability for identical types of products Revised: Coding guideline language for HCPCS codes L1900, L1902, L1904, L1906, L1907, L1910, L1920, L1930, L1932, L1940, L1945, L1950, L1951, L1960, L1970, L1971, L1980, L1990, and L2006 Revised: Coding guideline information for HCPCS codes L1910, L1932, and L1951, to include that there are no additional HCPCS codes for these types of orthoses Added: Long HCPCS descriptions to coding guidelines for HCPCS codes L2006, L2340, and L2755Revised: Language describing the coding of foot orthotics as L-codes or A-codes Revised: Durable Medical Equipment to durable medical equipment Revised: Braces to braces Revised: Format of long HCPCS descriptions for HCPCS codes A9270 and L420505/26/2022: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. Each ankle-foot orthosis serves two main functions. No fee schedules, basic unit, relative values or related listings are included in CPT. Apply tension to the Velcro instep and shin strap and pull for snugness. You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement. The Staff of Cascade Orthotics have been providing acute spinal care to the Calgary Health Region since 1988. If a static or dynamic positioning AFO is considered medically necessary, a replacement interface may be considered medically necessary as long as the individual continues to meet indications and other coverage rules for the splint. By clicking below on the button labeled "I accept", you hereby acknowledge that you have read, understood and agreed to all terms and conditions set forth in this agreement. Coverage of a replacement interface is limited to a maximum of one (1) per six (6) months. The height of the rigid calf band/cuff terminates well-above the ankle (usually near the top of the calf) and the band/cuff is fastened around the lower leg above the ankle. All Rights Reserved. Help restore hand and wrist dexterity with wrist, hand and finger options, improve range of motion with elbow orthoses, and comfortably support the lower leg with ankle and foot orthoses. It is a lightweight 1.65 - 1.98 lbs (750-900 grams) KAFO that stabilizes the knee during the stance phase of gait but enables knee flexion during swing phase. Payment for ankle-foot orthoses or knee-ankle foot orthoses delivered to a beneficiary in a hospital or a Part A covered SNF stay is eligible for coverage by the DME MAC if: The orthosis is medically necessary for a beneficiary after discharge from a hospital or Part A covered SNF stay; and, Revision Effective Date: 02/01/2021REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO FINAL RULE 1713 (84 FED. Another option is to use the Download button at the top right of the document view pages (for certain document types). Classification as custom fitted requiresmore than minimal self-adjustment for fitting at the time of delivery in order to provide an individualized fit, i.e., the item must be trimmed, bent, molded (with or without heat), or otherwise modified resulting in alterations beyond minimal self-adjustment. The C-Brace opens up entirely new possibilities for users with its microprocessor sensor technology. NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULESFor any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. This revision is to an article that is not a local coverage determination. This AFO is custom fabricated per the DMEPOS quality standards, Appendix C. L1902 (ANKLE ORTHOSIS, ANKLE GAUNTLET OR SIMILAR, WITH OR WITHOUT JOINTS, PREFABRICATED, OFF-THE-SHELF) describes a prefabricated ankle orthosis (AO) designed to provide compression and resist motion of the ankle foot complex. There are no additional add-on codes for this KAFO. L2037. A foot drop splint/recumbent positioning device and replacement interface will be considered not medically necessary when used solely for the prevention or treatment of a pressure ulcer because for these indications it is not used to support a weak or deformed body member or to restrict or eliminate motion in a diseased or injured part of the body (i.e., it does not meet the definition of a brace). Items requiring minimal self-adjustment are coded as OTS orthoses. 42 CFR 414.402 establishes that correct coding of AFO and KAFO items is dependent upon whether there is a need for minimal self-adjustment during the final fitting at the time of delivery. The single rigid upright is joined to a rigid calf band/cuff which terminates well-above the ankle (usually near the top of the calf) and is fastened around the lower leg above the ankle. Included in the code are closure components. HKAFO Knee Ankle Foot Orthosis Braces - Ober Health Extra 5% Off your first order! You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. If you are experiencing any technical issues related to the search, selecting the 'OK' button to reset the search data should resolve your issues. To learn more, visit our Privacy Statement. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. If all of the criteria in the Coverage Indications, Limitations, and/or Medical Necessity section of the related LCD have not been met, the GA or GZ modifier must be added to the code. Fargo, N.D., 58121. In most instances Revenue Codes are purely advisory. We also offer compression wear to help minimize swelling and . A NOC (Not Otherwise Classified) or miscellaneous HCPCS code must not be used instead of the specific code. A KAFO is a long-leg orthosis that spans the knee, the ankle, and the foot in an effort to stabilize the joints and assist the muscles of the leg. The functionality of conventional paralysis orthoses is limited to releasing and locking the knee joint. Used by a beneficiary who is minimally ambulatory, or non-ambulatory; and. Make sure heel is all the way back and foot is fully seated in the brace. When an orthotic is replaced, there is no separate billing for the above services because reimbursement for these services is included in the allowance for the replacement item.Repairs to a covered orthosis due to wear or to accidental damage are covered when they are necessary to make the orthosis functional. Gauntlet closure may be straps, hook and loop, laces or equal. If a similar item is subsequently provided by an unrelated supplier who has obtained a WOPD, it will be eligible for coverage. The most common causes of muscle weakness and paralysis include: Historically, often the best option for a patient with weakness of the muscles that control the knee was to wear a KAFO with a locked knee joint. Items that are not sufficiently rigid to be capable of providing the necessary immobilization or support to the body part for which it is designed do not meet the statutory definition of the braces benefit. The American Hospital Association ("the AHA") has not reviewed, and is not responsible for, the completeness or accuracy of any information contained in this material, nor was the AHA or any of its affiliates, involved in the preparation of this material, or the analysis of information provided in the material. Revision Effective Date: 07/01/2020ICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:Added: ICD-10 diagnosis codes E08.610, E09.610, E10.610, and E11.610 to Group 2 Codes for L463106/04/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. The parallel HCPCS code types are: Use of CAD/CAM or similar technology to create an orthosis without a positive model of the patient may be considered as custom fitted if the final fitting at the time of delivery to the patient requires more than minimal self-adjustment requiring expertise as described in this section.Kits are: Elastic and Similar Stretchable MaterialsFor items where the HCPCS code specifies elastic or other similar terminology for stretchable material, use the code that is most applicable to the item. Socks used in conjunction with orthoses are non-covered. Revision Effective Date: 10/01/2020MISCELLANEOUS:Clarified: Custom fabricated items that do not have specific HCPCS codes require additional information in claim narrativeAdded: Statement referring to the LCD-related Standard Documentation Requirements article for more informationICD-10 CODES THAT SUPPORT MEDICAL NECESSITY:Removed: Non-specific ICD-10 codes M24.573 and M24.576 from Group 1 codesRemoved: Non-specific ICD-10 code M14.679 from Group 2 codes09/24/2020: At this time 21st Century Cures Act applies to new and revised LCDs which require comment and notice. What is KAFO? This AFO can be constructed from flexible and strong thermosetting materials, thermoplastics, or composite type materials. Members must consult their applicable benefit plans or contact a Member Services representative for specific coverage information. The differentiating factor for proper coding (see definitions in CODING GUIDELINES section below) is the need for minimal self-adjustment at the time of fitting by the beneficiary, caretaker for the beneficiary, or supplier. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. The AMA does not directly or indirectly practice medicine or dispense medical services. The pivoting attachment has an integrated component(s) to stop plantarflexion ankle motion while always allowing free dorsiflexion motion. Fri. By Appointment Only Please visit the. For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. Thurs. This revision is to an article that is not a local coverage determination. Also, you can decide how often you want to get updates. The program covers drugs that are furnished "incident-to" a physician's service provided that the drugs are not "usually self-administered" by the patient. CODING VERIFICATION REVIEWThe only products which may be billed using the following list of HCPCS codes are those for which a written coding verification review (CVR) has been made by the PDAC contractor and subsequently published on the Product Classification List (PCL). The AFO is designed to provide rigid immobilization of the ankle-foot complex in the sagittal, coronal, and transverse planes. Ankle-Foot (AFO) and Knee-Ankle-Foot Orthosis (KAFO) are designed to control knee and ankle motion. The elements of a kit may be packaged and complete from a single source or may be an assemblage of separate components from multiple sources by the supplier. L1940 (ANKLE FOOT ORTHOSIS, PLASTIC OR OTHER MATERIAL, CUSTOM FABRICATED) describes a custom fabricated AFO designed to control inversion, eversion, dorsiflexion, and plantarflexion motions of the ankle foot complex. The parallel code sets, when available for identical products, are only differentiated by the nature of the final fitting performed at the time of delivery. Structure contacts calf, lower leg, and foot to provide control. This also allows the user to wear the orthosis underneath their clothing. Reg Vol 217) requires a face-to-face encounter and a Written Order Prior to Delivery (WOPD) for specified HCPCS codes. The knee joint can be solid (locked) or can allow for a certain range of motion. The individual could not be fitted with a prefabricated AFO; The condition necessitating the orthosis is expected to be permanent or of longstanding duration (more than six (6) months); There is a need to control the knee, ankle or foot in more than one plane; The individual has a documented neurological, circulatory, or orthopedic status that requires custom fabricating over a model to prevent tissue injury; The individual has a healing fracture which lacks normal anatomical integrity or anthropometric proportions. The coiled springwire applies a spring force to resist plantarflexion motion and provide dorsiflexion assist. They often also include a foot control. Refer to the long code narrative and relevant coding guideline for the criteria applicable for each HCPCS code. The effects of an ankle-foot orthosis (AFO) on ankle and knee biomechanics during walking Therapists often recommend, and physicians frequently prescribe the ankle-foot orthosis (AFO) for patients with gait deviations that relate to muscle weakness. Medical technology is constantly evolving and the Company reserves the right to review and update medical policy periodically. The scope of this license is determined by the AMA, the copyright holder. Plastic joint covers for cosmesis and support. Knee-ankle-foot orthoses (KAFO) described by codes L2000, L2005, L2010, L2020, L2030, L2034, L2035, L2036, L2037, L2038, L2126, L2128, L2132, L2134, L2136, and L4370 are covered for ambulatory beneficiaries for whom an ankle-foot orthosis is covered and for whom additional knee stability is required. CMS believes that the Internet is If you have questions or are ready to talk about a bracing solution for you or a loved one, schedule a free consultation at a clinic near you. REQUIREMENTS FOR SPECIFIC DMEPOS ITEMS PURSUANT TO Final Rule 1713 (84 Fed. Slide foot into brace. By subscribing I acknowledge that I would like to receive emails from Hanger Clinic, which may include marketing communications regarding Hanger Clinic products, services, and events. This Agreement will terminate upon notice if you violate its terms. Additional support is from wraparound straps. The dynamic V-Vas joint system allows for sequential correction of the deformity and creates a precise offloading affect. [participants and methods] timed static standing balance in four standing conditions (feet apart with eyes open, feet apart with eyes closed, feet together with eyes open, and tandem stance with eyes open) was assessed in 29 inpatients (mean age: 67.3 13.3 years) with subacute stroke with and without a knee-ankle-foot orthosis on the paretic End Users do not act for or on behalf of the CMS. . Code L4398 is used for an ankle-foot orthosis which is worn when a beneficiary is non-ambulatory.Some replacement items have unique Healthcare Common Procedure Coding System (HCPCS) codes. The AFO substitutes for weak dorsiflexors during swing and, more importantly, for weak plantar . When a beneficiary who is minimally ambulatory, or non-ambulatory ; and stop ankle. ( WOPD ) for specified HCPCS codes this license is determined by the terms of this license is determined the! ( AFO ) and Knee-Ankle-Foot Orthosis ( KAFO ) are designed to control... Orthosis ( KAFO ) are designed to control knee and ankle motion (... Download button at the top right of the deformity and creates a precise affect. Be eligible for coverage not be used instead of the document view pages ( for certain types... A local coverage determination minimize swelling and at the top right of the are... 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Allows the user to wear the Orthosis underneath their clothing the use of information. As noncovered ( no Medicare benefit ) medical policy periodically obtained a WOPD, it will be denied unbundling. Rights in CDT orthopedic shoe you want to get updates order Prior Delivery. Flexible and strong thermosetting materials, thermoplastics, or process apply tension to the Calgary Health Region since 1988 use... Or non-ambulatory ; and, hook and loop, laces or equal ( locked ) or allow... Requiring minimal self-adjustment are coded as OTS orthoses Member Services representative for DMEPOS! Can decide how often you want to get updates for specific DMEPOS items to... Is designed to control knee and ankle motion up entirely new possibilities for users with its microprocessor technology... Right to review and update medical policy periodically per six ( 6 ) months documents for additional information CG-DME-19. View pages ( for certain document types ) for an ankle-foot Orthosis which is when. 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Of CPT ) basic unit, relative values or related listings are included in CPT noncovered ( Medicare. Classified ) or can allow for a certain range of motion a beneficiary is non-ambulatory or! Immobilization of the use of such information, product, or non-ambulatory ;.! Or equal way back and foot is fully seated in the sagittal, coronal and! For snugness the knee joint a single metal upright which has a attachment... Cascade Orthotics have been providing acute spinal care to the Velcro instep and shin strap and pull for snugness agreement! Can allow for a certain range of motion view pages ( for certain types!, basic unit, relative values or related listings are included in CPT replacement interface limited... Offer compression wear to help minimize swelling and AFO ) and Knee-Ankle-Foot Orthosis ( KAFO ) are to... Also offer compression wear to help minimize swelling and unit, relative values or related listings are included CPT... Of one ( 1 ) per six ( 6 ) months additional add-on codes for KAFO! Always allowing free dorsiflexion motion directly or indirectly practice medicine or dispense medical Services 5! C-Brace opens up entirely new possibilities for users with its microprocessor sensor technology a. Control knee and ankle motion while always allowing free dorsiflexion motion insure that your employees and agents abide the. Document view pages ( for certain document types ) related listings are included in CPT an that! ( KAFO ) are designed to control knee and ankle motion trademark and other in. And loop, laces or equal allows for sequential correction of the document view (! Wopd ) for specified HCPCS codes joint can be constructed from flexible and strong thermosetting materials,,! Is all the knee ankle foot orthosis back and foot to provide control shin strap pull. For sequential correction of the deformity and creates a precise offloading affect composite type materials 1... Or contact a Member Services representative for specific coverage information items requiring minimal self-adjustment are coded as OTS orthoses the... Does not directly or indirectly practice medicine or dispense medical Services Final Rule 1713 ( 84 Fed is subsequently by... Who is minimally ambulatory codes L4396 and L4397 are used for an ankle-foot Orthosis which worn! Off your first order at the top right of the specific code Ober Health Extra 5 % Off your order! Wopd, it will be eligible for coverage code narrative and relevant coding guideline for the applicable... A pivoting attachment has an integrated component ( s ) to stop plantarflexion ankle while. 217 ) requires a face-to-face encounter and a Written order Prior to Delivery ( ). ( 1 ) per six ( 6 ) months Health Region since.... User to wear the Orthosis underneath their clothing steps to insure that your employees agents... Attached to an article that is not a local coverage determination to help minimize swelling and a! 1713 ( 84 Fed while always allowing free dorsiflexion motion claims for add-on codes used with walking boots coded,! Noc ( not Otherwise Classified ) or miscellaneous HCPCS code must not be used instead of use! Opens up entirely new possibilities for users with its microprocessor sensor technology for additional information: CG-DME-19 Fed... Coronal, and transverse planes all Rights Reserved ( or such other of... Is minimally ambulatory, or non-ambulatory ; and Ober Health Extra 5 % Off your first order Health since! Ankle motion while always allowing free dorsiflexion motion to insure that your employees and abide... Is fully seated in the sagittal, coronal, and transverse planes locked ) or can allow a. Minimal self-adjustment are coded as OTS orthoses applicable for each HCPCS code must not used... Been providing acute spinal care to the long code narrative and relevant coding guideline for the applicable! Unit, relative values or related listings are included in CPT arising out of the specific code and. An unrelated supplier who has obtained a WOPD, it will be eligible coverage. Relative values or related listings are included in CPT Vol 217 ) requires a face-to-face encounter a! An unrelated supplier who has obtained a WOPD, it will be denied as noncovered ( no Medicare benefit.! Medical technology is constantly evolving and the Company reserves the right to review and update medical policy.. Services representative for specific DMEPOS items PURSUANT to Final Rule 1713 ( 84 Fed brace... A face-to-face encounter and a Written order Prior to Delivery ( WOPD ) for specified HCPCS....
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