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Suggested HCPCS Codes

The responsibility for accurate coding lies with the patient care facility that selects the product, fits the patient, and bills for the service.

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. 

Suggested L-Codes for Prosthetics

Prosthetics Suggested Coding  Download (PDF | 0.5 MB)
MPK Coding Options  Download (PDF | 0.2 MB)
Myobock and Bebionic Coding Options  Download (PDF | 0.1 MB)
 

Suggested L-Codes for Orthotics

Orthotics Suggested Coding Download (PDF | 0.5 MB)

 

PDAC Coding Verifications

The Medicare Pricing Data, Analysis and Coding (PDAC) group conducts coding reviews on durable medical equipment, orthotics, prosthetics and supplies (DEMPOS).  The coding verification process is voluntary, except when mandated by Medicare for billing purposes.  To see the DEMPOS Product Classification List, visit dmepdac.com.

The assignment of the HCPCS codes in these letters is not an approval or endorsement of the products by Medicare or the PDAC contractor, nor does it imply or guarantee claim reimbursement or coverage.  Always refer to the specific Local Coverage Determination (LCD) or Policy Article for correct billing instructions.

Check the appropriate link below to find and download the PDAC coding verification letters Ottobock has received for the product you are looking for.

Prosthetic Coding Verifications - Lower Limb

Product Coding Verification
3R60 Modular Polycentric Knee Joint Download (PDF | 110.7 KB)
3R80 Rotary Hydraulic Knee Joint Download (PDF | 110.7 KB)
7E10 Helix3D-Hip PDAC Coding Verifications Download (PDF | 80.9 KB)
1C61 Triton Vertical Shock Foot PDAC Coding Verification Download (PDF | 91.9 KB)
1T01 TLM TaiLor Made Foot PDAC Coding Verification Download (PDF | 126 KB)
 
 

Orthotic Coding Verifications - Hand & Finger

4024 Manu Rheuma Flex  Download (PDF | 1.2 MB)
4025 Manu Rheuma Pollex  Download (PDF | 1.2 MB)
4026 Diagonal Comfort  Download (PDF | 37.1 KB)
4030 Manu Direxa Basic  Download (PDF | 1.2 MB)
4032 Manu Direxa Basic W&T  Download (PDF | 1.2 MB)
4055 Manu Comfort  Download (PDF | 1.2 MB)
4058 Manu ComforT Stable  Download (PDF | 35.0 KB)
4067 Children’s Wrist Support  Download (PDF | 1.2 MB)
4084 Thumboform Short  Download (PDF | 1.2 MB)
4085 Thumboform Long  Download (PDF | 1.2 MB)
4086 Thumboform X-Long  Download (PDF | 1.2 MB)
4088 Wristoform  Download (PDF | 1.2 MB)
50A4 Rhizo Forsa  Download (PDF | 1.2 MB)
50P10 Manu Immobil  Download (PDF | 1.2 MB)
50P11 Manu Immobil Long  Download (PDF | 1.2 MB)
28P211 Thumb Spica Brace  Download (PDF | 265.2 KB)
28P212 Ottobock Wrist Brace  Download (PDF | 271.0 KB)
 

Orthotic Coding Verifications – Cervical

50C81 Mini Minerva - Multiple Post Collar  Download (PDF | 80.5 KB)
50C80 Minerva - Multiple Post Collar  Download (PDF | 80.5 KB)
50C71 Cervical Thoracic Orthosis Coding Verification  Download (PDF | 1.2 MB)
50C72 Cervical Orthosis Coding Verification  Download (PDF | 1.2 MB)
50C73 Ottobock Universal Cervical Collar  Download (PDF | 35.0 KB)
50C74 Ottobock Cervical Immobilizer Coding Verification  Download (PDF | 35.1 KB)
50C76 Value Collar Coding Verification  Download (PDF | 1.1 MB)
 

Orthotic Coding Verifications – Shoulder & Arm

4801 Epi Elbow Support  Download (PDF | 35.2 KB)
50A8 Omo Immobil Sling  Download (PDF | 35.2 KB)
50A9 Omo Immobil Sling, Abduction  Download (PDF | 35.2 KB)
50A10 Omo Immobil  Download (PDF | 887.4 KB)
5055 Acro ComforT  Download (PDF | 39.2 KB)
7126 Shoulder Support  Download (PDF | 39.2 KB)
 

Orthotic Coding Verifications – Hip, Back, Spine

28L10 Tubingen Hip Orthosis, 28L20 Hip Abduction Orthosis  Download (PDF | 1.2 MB)
28R18 Hyperextension Orthosis  Download (PDF | 1.2 MB)
28R27 Cybercross Orthosis  Download (PDF | 1.2 MB)
28R140 Dorso Arexa  Download (PDF | 1.2 MB)
3002 / 0300204*. Dosi-X Back Support  Download (PDF | 1.5 MB)
3042 / 0304204*. Dosi-X Back Support with Hip Development  Download (PDF | 1.5 MB)
50C82 Ottobock Universal Cervical Orthosis  Download (PDF | 84 KB)
50R30 Lumbo TriStep  Download (PDF | 1.5 MB)
50R150 Ottobock Low-Profile LSO Lite, Ottobock Low-Profile LSO Coding Verification  Download (PDF | 1.2 MB)
50R152 Ottobock TLSO  Download (PDF | 1.5 MB)
50R153 Ottobock Fulcrum LSO Coding Verification  Download (PDF | 1.2 MB)
50R211 Ottobock Trimod  Download (PDF | 133 KB)
50R215 Ottobock Passport LSO  Download (PDF | 84 KB)
50R218-2 Ottobock Option 2 LSO  Download (PDF | 84 KB)
50R218-3 Ottobock Option 3 LSO  Download (PDF | 133 KB)
50R300 Dyneva (effective 01-30-2017)  Download (PDF | 128 KB)
50R319-631 Ottobock Multi 631  Download (PDF | 84 KB)
50R319-637 Ottobock Multi 637  Download (PDF | 133 KB)
50R320N Ottobock TLSO X4  Download (PDF | 75 KB)
 

Orthotic Coding Verifications – Knee

50K29 OA Restore  Download (PDF | 35.7 KB)
50K30 Xeleton ACl, PCL, and CI Knee Brace  Download (PDF | 1.9 MB)
50K176 Post-op knee brace  Download (PDF | 35.3 KB)
50K318 OA Restore Knee Orthosis  Download (PDF | 35.7 KB)
8060 Genu Immobil 0º  Download (PDF | 1.2 MB)
8062 Genu Immobil 20º  Download (PDF | 1.2 MB)
8320 Patella Pro  Download  (PDF | 1.5 MB)
8353 Genu Direxa Wraparound, Genu Direxa  Download  (PDF | 1.3 MB)
8356 Genu Direxa Wraparound, Genu Direxa  Download (PDF | 1.3 MB)
8357N Genu Direxa Stable  Download (PDF | 1.4 MB)
8359N Genu Direxa Stable Long  Download (PDF | 1.4 MB)
8367N Genu Direxa Stable, Wraparound  Download (PDF | 1.4 MB)
8368N Genu Direxa Stable Long, Wraparound  Download (PDF | 1.4 MB)
50K322 Genu Immobil Adjuster  Download (PDF | 0.4 MB)
50K324 Agilium Reactive  Download (PDF | 0.4 MB)
 

Orthotic Coding Verifications – Foot & Ankle

50S3 Malleo Sprint  Download (PDF | 1.1 MB)
50S8 Malleo TriStep  Download (PDF | 1.6 MB)
50S9 Malleo Direxa Stirrup  Download (PDF | 1.0 MB)
50S10-1 Malleo Immobil Walker, high  Download (PDF | 1.0 MB)
50S12-1 Malleo Immobil Air Walker, high  Download  (PDF | 1.0 MB)
50S14-1 Malleo Immobil Air Walker, low  Download  (PDF | 1.2 MB)
50S15-1 Malleo Immobil ROM Walker  Download (PDF | 1.0 MB)
50S16 Malleo Sprint light  Download (PDF | 1.0 MB)
50S20-1 Malleo Immobil Night Splint  Download (PDF | 1.0 MB)
50S156 Malleo Immobil Walker, wide  Download (PDF | 111.8 KB)
50S157 Malleo Immobil Air Walker, wide  Download  (PDF | 111.8 KB)
50S159 Ottobock Walker Boot  Download  (PDF | 111.8 KB)
7772 Malleo Arexa  Download (PDF | 177 KB)
50R211 Trimod LSO  Download (PDF | 81.5 KB)
 

Orthotic Coding Verifications – AFO

28U11 Ottobock WalkOn  Download (PDF | 114.1 KB)
28U23 Ottobock WalkOn Trimmable  Download (PDF | 114.1 KB)
28U9, 28U15, 28U16, 28U17, 28U18 Ottobock AFO  Download (PDF | 40.8 KB)
28U22 WalkOn Flex  Download (PDF | 82.2 KB)
28U24 WalkOn Reaction  Download (PDF | 111.8 KB)
 

Orthotic Coding Verifications – KAFO & HKAFO

E-MAG Active  Download (PDF | 76.8 KB)
FreeWalk KAFO  Download (PDF | 76.0 KB)
RGO Hip Joint System  Download (PDF | 80.8 KB)