Thank you to our members for your support in preserving our rights as OTs and PTs to fabricate and dispense orthoses to Medicare beneficiaries. It is important for us to work together on this issue and to coordinate our efforts with AOTA, APTA and HTCC.

L - codes
Coding and reimbursement

Elastic Garments – Noncovered
CMS has determined that elastic garments do not meet the statutory definition of a brace because they are not rigid or semi-rigid devices. Therefore, effective for claims with dates of service on or after April 1, 2009, these items will be denied as noncovered, no benefit category.
This determination applies to the following HCPCS codes:

L3700 Elbow orthosis, elastic with stays, prefabricated
L3701 Elbow orthosis, elastic, prefabricated
L3909 Wrist orthosis, elastic, prefabricated
L3911 Wrist hand finger orthosis, elastic, prefabricated

For more information on these changes, please click here.

Updates
Check back frequently for updates that may affect your practice.

CMS (Centers for Medicare & Medicaid Services)

NBAOS (National Board of Accreditation for Orthotic Suppliers)

FAQs (This is a member only resource)