New Codes Affect Multiple Bracing LCDs/Policy Articles
What You Need to Know
The creation of 4 new codes describing concentric adjustable torsion-style mechanisms used for the treatment of contractures has led to the revision of multiple LCDs and Policy Articles. Those codes are:
E1813: DYNAMIC ADJUSTABLE KNEE EXTENSION ONLY DEVICE, INCLUDES SOFT INTERFACE MATERIAL
E1814: DYNAMIC ADJUSTABLE KNEE FLEXION ONLY DEVICE, INCLUDES SOFT INTERFACE MATERIAL
E1822: DYNAMIC ADJUSTABLE ANKLE EXTENSION ONLY DEVICE, INCLUDES SOFT INTERFACE MATERIAL.
E1823: DYNAMIC ADJUSTABLE ANKLE FLEXION ONLY DEVICE, INCLUDES SOFT INTERFACE MATERIAL
The following LCD's and Policy Articles are affected:
- Ankle-Foot/Knee-Ankle-Foot Orthosis (references all 4 codes);
- Knee Orthoses (references E1813 and E1814).
What this Means for You
If an AFO, KAFO, or knee orthosis (a) includes a concentric adjustable torsion style mechanism described by one of the these new L codes, and (b) that device satisfies the applicable coverage criteria, you can now bill for them (effective Jan. 1, 2025). Make sure that your EMR has been updated to include these new codes and their fees.
You can access the AFO/KAFO LCD here, the AFO/KAFO Policy Article here, the Knee Orthoses LCD here, and the Knee Orthoses Policy Article here.