Resources to Help Bill Knee Orthotics Correctly

Are you finding it hard to understand what documentation you need from the practitioner for knee orthoses? A Clinician Letter written by the medical directors for Noridian and CGS has detailed information regarding expectations from the clinician. This letter is a great resource to provide to clinicians in order to obtain the information required in the medical record.

Would a Documentation Checklist for Knee Orthoses at a glance be helpful? The one on our website provides hyperlinks to many resources for this policy including the LCD, Policy Article, Standard Written Order, Face-to-Face and Written Order Prior to Delivery (WOPD), Prior Authorization, Continued Need, and on. It also provides a succinct list of what should be in the medical record for each code. And just a reminder, medical necessity must be supported by one of the specific ICD-10-CM codes listed in the Knee Orthoses LCD-related Policy Article (A52465) and that code must be included on the claim.

The Clinician Checklist for Knee Orthoses - Custom and Prefabricated is a short document indicating the medical documentation required for these two categories of orthotics.

We hope these resources, including our Orthotics webpage, can help you bill successfully.


            Last Updated Tue, 25 Oct 2022 17:09:14 +0000