PDAC Required Verification for Specific Knee and Back Braces
Important for products billed with HCPCS L1832, L1833, and L1851.
In conjunction with the Prior Authorization of products billed with HCPCS L1832, L1833, and L1851, PDAC is now requiring these products to be PDAC verified by October 10, 2022.
Manufacturers of braces billed with these HCPCS must submit a Coding Verification Application to PDAC for verification. Upon review, the product will be listed on the PDAC site (www.dmepdac.com) so suppliers can decide exact HCPCS codes to bill.
After October 10, 2022, only those products listed on the PDAC site with these HCPCS codes will be billable.
The requirements for coding verification of knee braces are new. Most spinal braces, including those now under Prior Authorization requirements, have been reviewed and listed on PDAC per an earlier requirement.
What Does This Mean for You?
For claims with dates of service on or after October 10, 2022, be sure to check the PDAC site to make sure the product is listed with the proper HCPCS code. You do not need to have a copy of the manufacturer’s coding verification letter.
Go here for more information about this coding verification requirement.