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Official Description

Addition to lower extremity orthosis, femoral length sock, fracture or equal, each
Short Descr Femoral lgth sock fx or equa
Coverage Carrier Priced
Pricing Indicator(s) 38 – Supplies And Surgical Dressings - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS D1F – Prosthetic/Orthotic devices
TOS Code(s) P – Lump sum purchase of DME, prosthetics, orthotics
Added Date 1/1/1989
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE 0
MUE 0
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
KX Requirements specified in the medical policy have been met
RT Right side (used to identify procedures performed on the right side of the body)
LT Left side (used to identify procedures performed on the left side of the body)
GA Waiver of liability statement issued as required by payer policy, individual case
GP Services delivered under an outpatient physical therapy plan of care
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZ Item or service expected to be denied as not reasonable and necessary
RA Replacement of a dme, orthotic or prosthetic item
Date
Action
Notes
1989-01-01 Added Code added 1/1/1989
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Description
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