The code descriptors for some commonly used DME-related HCPCS codes will change effective April 1. These positive changes eliminate the need to use HCPCS L2999 (Lower extremity orthoses, not otherwise specified) when these items are dispensed "off-the-shelf.”
- The HCPCS L1932 code descriptor will change to: "Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise.”
- HCPCS L1933 will be added as a new code: “Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf”
With these changes, if this item is dispensed “off-the-shelf,” L1933 should be submitted. If this item is dispensed “custom fitted,” L1932 should be submitted.
- The HCPCS L1951 code descriptor will change to: "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise.”
- HCPCS L1952 will be added as a new code: "Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf”
With these changes, if this item is dispensed “off-the-shelf,” L1952 should be submitted. If this item is dispensed “custom fitted,” L1951 should be submitted.
Reference: https://www.cms.gov/files/document/2024-hcpcs-application-summary-biannual-2-2024-non-drug-and-non-biological-items-and-services-pdf.pdf
