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Official Description

Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf
Short Descr Hfo nontorsion jnts 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
GA Waiver of liability statement issued as required by payer policy, individual case
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)
50 Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GO Services delivered under an outpatient occupational therapy plan of care
GZ Item or service expected to be denied as not reasonable and necessary
KX Requirements specified in the medical policy have been met
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
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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