Reimbursement Update for Splints
The Medicare Pricing, Data Analysis and Coding (PDAC) Contractor, the Medicare contractor responsible for providing durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) coding and pricing information, recently announced items that will be denied as noncovered effective April 1, 2009.
CMS determined that elastic garments do not meet the statutory definition of a brace because they are not rigid or semi-rigid devices. The list of noncovered codes the following codes for splints: L3700, L3701, L3909, and L3911. See the PDAC announcement for more information.