Correct Billing for Custom Fitted Orthotics When No Custom Fitting Is Completed With No off the Shelf Equivalent

When a prefabricated custom fit orthosis is being provided directly to a beneficiary and no custom fitting is completed at the time of delivery, the corresponding prefabricated off-the-shelf HCPCS code must be billed on the claim. When there is not a corresponding prefabricated off-the-shelf HCPCS code for the HCPCS categorized as Custom Fitted Orthotics, miscellaneous codes must be used for billing. Additional information can be found on our Orthotics webpage.

 

            Last Updated Thu, 03 Jun 2021 20:24:06 +0000