Effective July 1, 2012: Local Coverage Determination (LCD) for Knee Orthoses (L27263)

Medicare Approves An Addition Code for Custom Knee Bracing.

For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements. For the items addressed in this local coverage determination, the criteria for “reasonable and necessary”, based on Social Security Act §1862(a)(1)(A) provisions, are defined by the following indications and limitations of coverage and/or medical necessity.  Please click here for the Knee Orthoses LCD

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Categories: DME Coding, DME Information, Medicare

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