CGS Connect - Update
This article summarizes the recent updates to the CGS Connect pre-claim review program, including the addition of the Lower Limb Prostheses policy group and new orthotic HCPCS codes.
What You Need to Know
In our previous post on Voluntary Pre-Claim Reviews, we discussed CGS Connect and how it can be used to ensure medical records meet LCD and Policy Article coverage criteria before submitting a claim to Medicare. Recently, CGS updated its list of HCPCS codes that can be submitted for review. The update not only includes additional AFO and knee orthoses codes, but also two lower limb prosthetic codes. Currently, CGS Connect is accepting submissions for the following orthotic and prosthetic HCPCS codes (updates are in bold):
- Ankle Foot Orthoses: L1902, L1906, L1930, L1971, L4350, L4360, L4361, L4386, L4387, L4396, L4397, and L4631
- Knee Orthoses: L1833, L1844, L1852 and L2397
- Spinal Orthoses: L0450 - L0458, L0630, L0632 - L0636, L0638, L0640 - L0647, and L0651
- Lower Limb Prostheses: L5700 and L5701
Note: This program is offered by CGS, so it is only applicable for claims sent to Jurisdictions B and C. Noridian does not have a similar voluntary pre-claim review service for Jurisdictions A or D at this time.
What this Means for You
CGS Connect is a voluntary service designed to provide you with education and help decrease denials for specific HCPCS codes. CGS continues to expand its support by not only adding new HCPCS codes, but also adding new policy groups to its list, such as Lower Limb Prostheses. To learn more about CGS Connect and view the most updated list of HCPCS codes, click the link for Jurisdiction B or Jurisdiction C.