Recommended HCPCS Coding for Hip Orthosis

The DME MACs and PDAC have issued a joint advisory article for billing HCPCS code L1686. Specifically, the article states that add on codes L2622 and L2624 cannot be used when billing for this brace.

The article further states that l1686 can be billed as an off the shelf brace or a custom fit brace. If a custom-fit brace is utilized, the documentation needs to indicate there is more than minimal adjust needed, what modifications were made, and the expertise of a certified orthotist or someone with specialized training is needed.

For reference, the complete advisory article can be found here: L1686 Prefabricated Hip Abduction Orthosis - Correct Coding.