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Official Description

Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated
Short Descr Ewh s/d uprt micro sensor
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 1/1/2019
APC Status Indicator Service Paid under Fee Schedule or Payment System other than OPPS
MUE 0
MUE 1
OTS Orthotic No
Date
Action
Notes
2024-01-01 Note Payment change (MOG, pricing indicator codes, anesthesia base units, Ambulatory Surgical Centers)
2020-10-01 Changed Long description changed.
2019-01-01 Added Code added.
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