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David McGill Blogger

PROPRIO FOOT Coding Explained

Posted by David McGill | August 08, 2012

A frequent question we get asked is why we do not suggest add-on codes for PROPRIO FOOT.

The short answer is simple: when Medicare created code L5973 in 2010 to describe PROPRIO FOOT, its letter approving the code explicitly prohibited it:

[Our goal] is to establish language that is consistent with CMS’ intent to create a code that describes the entire system, and that is not intended to be used together with other codes. [Emphasis added]

Letter from CMS Coding Workgroup to Össur, Nov. 02, 2009

Based on this guidance, we believe that use of any add-on codes in conjunction with L5973 isn’t appropriate for Medicare claims. Please be sensitive to this when using L5973 for a microprocessor-controlled ankle-foot system.

If you would like to see a copy of the Medicare letter cited above, please do not hesitate to contact your Össur Area Manager.


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