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 Feb 19 , 2024