In January 2022, the Centers for Medicare and Medicaid Services (CMS) announced the expansion of the Medicare prior authorization program to include the following five spinal and knee orthosis codes, L0648, L0650, L1832, L1833, and L1851. While the existing Medicare prior authorization program for select lower limb prosthesis codes has been very successful to date, […]

This week, AOPA, in conjunction with its O&P Alliance partners, AAOP, ABC, BOC, and NAAOP, issued a joint statement on direct-to-consumer delivery models for custom orthotic and prosthetic care.  The full consensus statement can be read here.

On Thursday, March 31 the DME MACs and the PDAC released a comprehensive correct coding bulletin for all Upper Extremity Prostheses (UEP).  In the bulletin they stated that the correct coding of an UEP base code, and addition codes, are dependent on two main factors: the level of amputation and the prostheses’ power source. The […]