Article retired due to content incorporation into the applicable Local Coverage Determination or related Policy Article.

Original Effective Date: 09/02/2010
Revision Effective Date: 11/01/2013

Effective for claims with dates of service on or after January 1, 2011, the only products which may be billed using code L4380 (Pneumatic knee splint, prefabricated, includes fitting and adjustment) are those for which a written coding verification has been made by the Pricing, Data Analysis, and Coding (PDAC) contractor.

Information concerning the documentation that must be submitted to the PDAC for a Coding Verification Request can be found on the PDAC web site www.dmepdac.com/review/index.html or by contacting the PDAC Contact Center at 877.735.1326. Once the products are coded by the PDAC they will be listed on the Product Classification List.