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Official Description

Lower extremity orthoses, not otherwise specified
Short Descr Lower extremity orthosis nos
Coverage Carrier Priced
Pricing Indicator(s) 46 – Supplies And Surgical Dressings - Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)
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 1/1/1982
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE 0
MUE Not applicable/unspecified.
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
KX Requirements specified in the medical policy have been met
LT Left side (used to identify procedures performed on the left side of the body)
RT Right side (used to identify procedures performed on the right side of the body)
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
AY Item or service furnished to an esrd patient that is not for the treatment of esrd
CR Catastrophe/disaster related
EY No physician or other licensed health care provider order for this item or service
GA Waiver of liability statement issued as required by payer policy, individual case
GL Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
GP Services delivered under an outpatient physical therapy plan of care
GW Service not related to the hospice patient's terminal condition
GX Notice of liability issued, voluntary under payer policy
KV Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
NU New equipment
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
RB Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair
ST Related to trauma or injury
T3 Left foot, fourth digit
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
1982-01-01 Added Code added 1/1/1982
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