Knee Orthoses (HCPCS L1833 & L1851) Notification of Service Specific Post-Payment Review

Noridian Jurisdiction D, DME MAC, Medical Review is initiating service specific post-payment medical record review of claims for the following HCPCS codes:

  • L1833: KNEE ORTHOSIS, ADJUSTABLE KNEE JOINTS (UNICENTRIC OR POLYCENTRIC), POSITIONAL ORTHOSIS, RIGID SUPPORT, PREFABRICATED, OFF-THE SHELF
  • L1851: KNEE ORTHOSIS (KO), SINGLE UPRIGHT, THIGH AND CALF, WITH ADJUSTABLE FLEXION AND EXTENSION JOINT (UNICENTRIC OR POLYCENTRIC), MEDIAL-LATERAL AND ROTATION CONTROL, WITH OR WITHOUT VARUS/VALGUS ADJUSTMENT, PREFABRICATED, OFF-THE-SHELF

Service specific reviews are initiated to prevent improper payments for services which present possible sustained or high-level payment errors. This review is being initiated based on data analysis identifying probable vulnerabilities.

Please see the Medical Record Review Results page for further information.

 

            Last Updated Wed, 16 Sep 2020 14:42:26 +0000