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~. - ~I. HealthCareRnancingAdministration "Now the Centers for Medicare & Medicaid Services (CMS)" MEDICARE Part A Intermediary Part B Carrier DME Regional Carrier October 16, 2001 Connie Wassermann, Product Manager RCAl 11236 47thStreet North Clearwater, FL 33762 Re: Universal Leg Brace-87ULB Post Operative Pin Knee Brace-77POP Basic Leg Brace-67BLB Respond ROM Knee Orthosis-37KCO (Re-Review) Flex Cuff Knee Orthosis-17KO (Re-Review) Premier Knee.Orthosis-27KCO (Re-Review) Universal Ann Brace-88UAB Arm-Wrist Brace-88AWE Dorsal Carpal Tunnel Splint-44DCT Dear Ms. Wassermann: The SADMERC and the four Durable Medical Equipment Regional Carriers (DMERCs) have completed the HCPCS Coding Verification Review and Re-Reviews for the above listed products manufactured by your company. Thisreviewresultedin a consensuscodingdecision. . It is our determination that the above listed products meet the characteristics and description of the HCPCS codes as assigned. Therefore, the correct Medicare billing codes for these products are Universal Leg Brace-87ULB- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support, prefabricated, includes fitting and adjustment. Post Operative Pin Knee Brace-77POP- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support, prefabricated, includes fitting and adjustment. Basic Leg Brace-67BLB- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support, prefabricated, includes fitting and adjustment. Respond ROM Knee Orthosis-37KCO (Re-Review)- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support, prefabricated, includes fitting and adjustment. Flex Cuff Knee Orthosis-17KO (Re-Review)- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support, prefabricated, includes fitting and adjustment. Premier Knee Orthosis-27KCO (Re-Review)- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support, prefabricated, includes fitting and adjustment. Universal Arm Brace-88UAB- L3760 Elbow orthosis, with adjustable position locking joint(s), prefabricated, includesfitting and adjustment. . Ann-Wrist Brace-88AWE- L3999 Upper limb orthosis, not otherwise specified. Palmetto GBA StatisticalAnalysisDurableMedicalEquipment Regional Carrier PostOfficeBox100143 . Columbia, SouthCarolina. 29202-3143 A HCFA Contracted Intermediary and Carrier

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Page 1: Now the Centers for Medicare & Medicaid Services (CMS

~. -~I.HealthCareRnancingAdministration

"Now the Centers for Medicare & Medicaid Services (CMS)"

MEDICARE

Part A IntermediaryPart B Carrier

DME Regional Carrier

October 16, 2001

Connie Wassermann, Product ManagerRCAl11236 47thStreet NorthClearwater, FL 33762

Re: Universal Leg Brace-87ULBPost Operative Pin Knee Brace-77POPBasic Leg Brace-67BLBRespond ROM Knee Orthosis-37KCO (Re-Review)Flex Cuff Knee Orthosis-17KO (Re-Review)Premier Knee.Orthosis-27KCO (Re-Review)Universal Ann Brace-88UABArm-Wrist Brace-88AWEDorsal Carpal Tunnel Splint-44DCT

Dear Ms. Wassermann:

The SADMERC and the four Durable Medical Equipment Regional Carriers (DMERCs) have completed theHCPCS Coding Verification Review and Re-Reviews for the above listed products manufactured by your company.Thisreviewresultedin a consensuscodingdecision. .

It is our determination that the above listed products meet the characteristics and description of the HCPCS codes asassigned. Therefore, the correct Medicare billing codes for these products are

Universal Leg Brace-87ULB- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support,prefabricated, includes fitting and adjustment.

Post Operative Pin Knee Brace-77POP- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigidsupport, prefabricated, includes fitting and adjustment.

Basic Leg Brace-67BLB- L1832 Knee Orthosis, adjustable knee joints, positional orthosis, rigid support,prefabricated, includes fitting and adjustment.

Respond ROM Knee Orthosis-37KCO (Re-Review)- L1832 Knee Orthosis, adjustable knee joints, positionalorthosis, rigid support, prefabricated, includes fitting and adjustment.

Flex Cuff Knee Orthosis-17KO (Re-Review)- L1832 Knee Orthosis, adjustable knee joints, positional orthosis,rigid support, prefabricated, includes fitting and adjustment.

Premier Knee Orthosis-27KCO (Re-Review)- L1832 Knee Orthosis, adjustable knee joints, positional orthosis,rigid support, prefabricated, includes fitting and adjustment.

Universal Arm Brace-88UAB- L3760 Elbow orthosis, with adjustable position locking joint(s), prefabricated,includesfitting and adjustment. .

Ann-Wrist Brace-88AWE- L3999 Upper limb orthosis, not otherwise specified.

Palmetto GBAStatisticalAnalysisDurableMedicalEquipmentRegionalCarrier

PostOfficeBox100143. Columbia,SouthCarolina. 29202-3143

A HCFA Contracted Intermediary and Carrier

Page 2: Now the Centers for Medicare & Medicaid Services (CMS

Dorsal Carpal Tunnel Splint-44DCT- L3938 Wrist-Band-Finger Orthosis, dorsal wrist, prefabricated, includesfitting and adjustment.

HCPCS code L3999 is a miscellaneous code and requires a complete description of the product when billing toMedicare. The description should include the manufacturer name, product name and the reason this item wasprescribed for the patient.

*Per our instruction from the Center for Medicare & Medicaid Services (CMS), "addition" codes are to be used oncustom fabricated braces only. It is improper billing to bill "addition" codes for prefabricated braces. Aprefabricated brace is all-inclusive.

This HCPCS coding decision applies to your products as they were presented to and reviewed by the SADMERCand the four DMERCs. Any modifications to these products could change .theHCPCS code and would need to bereviewed for coding verification. The assignment of a HCPCS code to these products should in no way beconstrued as an approval or endorsement of these products by SADMERC or Medicare, nor does it imply orguarantee claim reimbursement or coverage. For questions regarding claim coverage or reimbursement pleasecontact your regional DMERC.

If you do not agree with this coding decision, you may apply through the Alpha-Numeric Workgroup fora newcode for these products. This workgroup reviews applications for modification of permanent national Level nHCPCS codes. Please contact the HCPCS Coordinator at the Center for Medicare & Medicaid Services. Theaddress is provided below.

Centers for Medicare & Medicaid ServicesAttention: Kaye Riley, HCPCS Coordinator7500 Security BoulevardC5-08-27 .

Baltimore, MD 21244-1850

If you have any questions regarding this coding decision, please contact me at the address below or by telephone at(803) 763-8111.

i~~Bonnie Brooks, RNHCPCS Medical AnalystSADMERC

cc: DMERCs


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