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David McGill Blogger

PDAC Issues Pro-Flex Decision

Posted by David McGill | September 04, 2018

Össur has received a coding verification letter from the PDAC for its Pro-Flex prosthetic foot​. The PDAC concluded the L5999 is the code that should be used when submitting claims for Pro-Flex.

The History

Össur has always suggested L5999 for the Pro-Flex. However, in October 2017, the DME MACs issued guidance stating that L5979 was the appropriate code and suggested Össur take Pro-Flex to the PDAC for a formal coding verification. Össur ultimately elected to do so earlier this year.

What Does This Mean For You?

Effective immediately, L5999 is the code you should use when billing the Pro-Flex foot to third-party payors. If you need proof of this determination for payors in the future, you can go to the PDAC website for confirmation. Pending the appropriate update of PDAC's website, below is a copy of the first page of the PDAC's letter to Össur verifying Pro-Flex as an L5999 device.

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