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Reimbursement Toolkits

The product/device “Supplier” (defined as an O&P practitioner, O&P patient care facility, or DME Supplier) assumes full responsibility for accurate billing of Ottobock products. It is the Supplier’s responsibility to determine medical necessity; ensure coverage criteria is met; and submit appropriate HCPCS codes, modifiers, and charges for services/products delivered. It is also recommended that Supplier’s contact insurance payer(s) for coding and coverage guidance prior to submitting claims. Ottobock Coding Suggestions and Reimbursement Guides are based on reasonable judgment and are not recommended to replace the Supplier’s judgment. These recommendations may be subject to revision based on additional information or alpha-numeric system changes. 

Navigate to reimbursement for:

Lower Limb Prosthetics | Upper Limb Prosthetics | Advanced Orthotics 

Lower Limb Prosthetics Reimbursement

C-Leg Microprocessor-Controlled Prosthetic Knee

Reimbursement Tool Kit: Private Payer Reimbursement Reference Guide | MPK Coding Options | Private Payer Billing Tips
Documentation Guides: LLP Audit Survival Kit | LL Prosthetic Documentation Guide | LLP Documentation Check List | LL Documentation Fax Request | C-Leg Activity Chart Guide | LL Prosthetic Activity Chart | Documenting Functional Levels | Documenting a Replacement | C-Leg Appeal Guide
Clinical Studies:  C-Leg/Compact Clinical StudiesBilateral Studies and Articles
 

Compact Microprocessor-Controlled Prosthetic Knee

Reimbursement Tool Kit: Compact Reimbursement Reference Guide | MPK Coding Options
Documentation Guides: LLP Audit Survival Kit | LL Prosthetic Documentation Guide | LLP Documentation Check List | Documentation Fax Request | K2 MPK Documentation Tips | C-Leg Appeal Guide | LL Prosthetic Activity Chart | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: C-Leg/Compact Clinical Studies | K2 Clinical Studies | Systematic Review: MPKs for K2 Ambulators
 

Kenevo Microprocessor-Controlled Prosthetic Knee

Reimbursement Tool Kit: Kenevo Reimbursement Reference Guide | Billing Tips | MPK Coding Options
Documentation Guides: K2 MPK Documentation Tips | LL Prosthetic Activity Chart | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: K2 Clinical Studies | Systematic Review: MPKs for K2 Ambulators | Summary: Kenevo RCT
 

Genium Microprocessor-Controlled Prosthetic Knee

Reimbursement Tool Kit: Reimbursement Reference Guide | Coding and Billing | MPK Coding Options | Genium-X3 Evidence
Documentation Guides: LL Prosthetic Documentation Guide | LLP Documentation Check List | LL Prosthetic Activity Chart | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: Genium/X3 Clinical Studies
 

X3 Microprocessor-Controlled Prosthetic Knee

Reimbursement Tool Kit: Reimbursement Reference Guide | Coding and Billing | MPK Coding Options
Documentation Guides: LL Prosthetic Documentation Guide | LLP Documentation Check List | LL Prosthetic Activity Chart | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: Genium/X3 Clinical Studies
 

Harmony

Reimbursement Tool Kit: Reimbursement Reference Guide
Documentation Guides: LL Prosthetic Documentation Guide | LL Documentation Fax RequestHarmony Appeal Guide | Documenting Functional Levels | Documenting a Replacement
Clinical Studies:  Vacuum Studies Bibliography
 

Helix 3D Hip

Reimbursement Tool Kit: Helix Coding Justification | MPK Coding Options
Documentation Guides: LL Prosthetic Documentation Guide | LL Documentation Fax Request
PDAC Verification: Helix 3D Hip
Clinical Studies: Prosthetic Hip Clinical Studies
 

7E9 Hip Joint

Reimbursement Tool Kit: 7E9 Coding and Billing Tips | 7E9 Coding Options
Documentation Guides: LL Prosthetic Documentation Guide | LL Documentation Fax Request | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: Prosthetic Hip Clinical Studies
 

Triton smart ankle

Reimbursement Tool Kit: Reimbursement Reference Guide | MPK Coding Options
Documentation Guides: LL Prosthetic Documentation Guide | LL Documentation Fax Request | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: Microprocessor Foot Clinical Studies
 

Meridium Prosthetic Foot

Reimbursement Tool Kit: Reimbursement GuideMPK Coding Options
Documentation Guides: LL Prosthetic Documentation Guide | LL Documentation Fax Request | Documenting Functional Levels | Documenting a Replacement
Clinical Studies: Microprocessor Ankle/Foot Clinical Studies
 

Upper Limb Prosthetics Reimbursement

Myobock Solutions (includes bebionic hand and Dynamic Arm)

Reimbursement Tool Kit: Myobock-bebionic Coding Options | Myobock System Overview
Documentation Guides: UL Prosthetic Documentation Guide | UL Documentation Checklist | UL Documentation Fax Request | UL Daily Activity Chart
 

Myobock,  Above Elbow / Below Elbow

Reimbursement Tool Kit: Myobock System Overview
Documentation Guides: UL Prosthetic Documentation Guide | UL Documentation Checklist | UL Documentation Fax Request | UL Daily Activity Chart
 

Michelangelo-AxonBus Prosthetic System (APS) (includes AxonArm Ergo, AxonHook, AxonRotation)

Reimbursement Tool Kit: APS-Michelangelo Reimbursement Reference Guide | APS-Michelangelo Billing Tips | APS-Michelangelo Coding Options
Documentation Guides: UL Documentation Checklist | UL Daily Activity Chart
 

Pediatric UL Prosthetics

Tool Kit: Pediatric Coding Options (passive, body powered, and myoelectric)
 

Custom Orthotics Reimbursement

Agilium Freestep

Reimbursement Tool Kit: Reimbursement Reference Guide | Billing Tips for Private Pay | Documentation Request for Private Pay
 

Carbon Ankle Seven

Reimbursement Tool Kit: CA7 Coding Options | CA7 Billing Tips | CA7 Justification
Documentation Guides: AFO-KAFO Documentation Guide | AFO-KAFO Documentation Checklist | Documentation Fax Request
 

C-Brace

Reimbursement Tool Kit: Reimbursement Starter Packet | Reimbursement Guide | Coding and Billing Tips | Evaluation Form B | KAFO vs C-Brace Evidence
 

E-MAG Active

Reimbursement Tool Kit: Email reimbursement911@ottobock.com for coding and billing tips.
Documentation Guides: AFO-KAFO Documentation Guide | AFO-KAFO Documentation Checklist | Documentation Fax Request
PDAC Verification: E-Mag Active PDAC
Clinical Studies: Stance Control Clinical Studies
 

FreeWalk Stance Control

Documentation Guides: AFO-KAFO Documentation Guide | AFO-KAFO Documentation Checklist, Documentation Fax Request
PDAC Verification: FreeWalk PDAC Verification
Clinical Studies: Stance Control Clinical Studies
 

RGO Hip Joint

Reimbursement Tool Kit: RGO Coding and Billing Tips | RGO Justification
Documentation Guides: AFO-KAFO Documentation Guide | AFO-KAFO Documentation Checklist, Documentation Fax Request
PDAC Verification: RGO PDAC Verification