2024 Coding Update
While CMS has not yet updated its fee schedule for 2024, it has released information regarding orthotic and prosthetic L codes additions, revisions, and deletions. In this post, we'll review those changes so you know about the changes coming in January.
What You Need to Know
The following new L codes will become effective on January 1, 2024:
- L3161: Foot, adductus positioning device, adjustable (replaces K1015, which is being discontinued)
- L5615: Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control (replaces K1014, which is being discontinued)
- L5926: Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type (replaces K1022, which is being discontinued)
In addition, CMS's HCPCS Coding Committee recently announced that the following already-existing L-codes fall into the bracing Medicare benefit category:
- L2006: Bilateral hip, knee, ankle, foot device, powered, includes pelvic component, single or double upright(s), knee joints any type, with or without ankle joints any type, includes all components and accessories, motors, microprocessors, sensors
- L8701: Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated
- L8702: Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricate
What this Means for You
First, you should make sure that your EMR system updates at the beginning of 2024 to include all of these codes.
Second, CMS's decision to classify L2006, L8701, and L8702 as braces signals its recognition of how more advanced technologies should be part of that benefit category. We believe it is likely that the DME MACs will issue specific coverage criteria for these kinds of devices in the coming months. We will keep you updated if and when that happens.
As noted at the beginning of this post, we do not have 2024 fee schedule information as of the writing of this post. However, we expect CMS to release it any day now. We will share that with you as soon as it happens.