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Official Description

Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf
Short Descr Metacarp fx orthosis pre ots
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 1/1/2014
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE 0
MUE 2
OTS Orthotic No
CCS Clinical Classification 243 - DME and supplies
RT Right side (used to identify procedures performed on the right side of the body)
KX Requirements specified in the medical policy have been met
CG Policy criteria applied
GA Waiver of liability statement issued as required by payer policy, individual case
GO Services delivered under an outpatient occupational therapy plan of care
KV Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service
LT Left side (used to identify procedures performed on the left side of the body)
Date
Action
Notes
2014-01-01 Added Added
2014-01-01 ReActivated Recycled code. New description.
2008-01-01 Deleted Code Deleted effective 01/01/2008.
1982-01-01 Added Code Added 01/01/1982.
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Description
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