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New Off-The-Shelf Knee Orthosis Codes effective October 1, 2014

Today CMS posted its quarterly HCPCS update, which includes the following two new off-the-shelf (OTS) knee orthosis codes, effective October 1, 2014:

K0901 KO Single Upright Pre OTS – 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

K0902 KO Double Upright Pre OTS – Knee orthosis (KO), double 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

These new codes are the OTS versions of L1843 and L1845 respectively, and join the 23 other OTS codes that CMS established as part of the 2014 HCPCS update. This means that if a product currently coded L1843 or L1845 requires only minimal self-adjustment for fitting at the time of the delivery, these new OTS “K” codes are the ones that should be billed to the DME MACs.

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