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Linda Collins Blogger

New Knee Brace Codes and Fee Schedule for 2017

Posted by Linda Collins | December 20, 2016

Effective January 1, 2017, the K codes, K0901 and K0902, used for the off the shelf version of knee braces are no longer valid. The codes are being replaced with new codes. The new HCPCS codes are listed below:

HCPCS Code: L1851 (formerly K0901)

Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

HCPCS Code: L1843

Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

HCPCS Code: L1852 (formerly K0902)

Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

HCPCS Code: L1845

Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

What does this mean for you?

Claims with dates of service January 1, 2017, and after will need to reflect the new codes. A claim submitted with K0901 or K0902 may be denied. Use L1851 in place of K0901 and use L1852 in place of K0902. Be sure to update your internal forms and billing systems. Notify your electronic claims network of the update.

The off the shelf codes and the custom fit codes will be reimbursed the same, according to the 2017 Medicare Fee Schedule. For an updated list of products and 2017 Reimbursement amounts, download this document

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