July 10, 2024
Orthoses Prior Authorization Updates Reminder
Orthoses Prior Authorization Changes effective August 12, 2024:
- CMS added six orthoses HCPCS codes to the Required Prior Authorization List. We will begin accepting prior authorization requests for these codes on July 29, 2024:
- L0631, L0637, L0639, L1843, L1845, L1951
- CMS removed L1833 from the Required Prior Authorization list.
Orthoses Required Face-to-Face Encounter and Written Order Prior To Delivery (WOPD) Changes effective August 12, 2024:
- CMS added eight orthoses HCPCS codes to the Required Face-to-Face Encounter and WOPD List:
- L0635, L0636, L0638, L0639, L0640, L0651, L1845, and L1852
- CMS removed L1833 from the Required Face-to-Face Encounter and WOPD List.
Learn more about these requirements in MLN Matters Article SE20007.
CGS Online Tools
- Use the Prior Authorization Code Lookup to check for HCPCS codes that are on the Required Prior Authorization List
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- Use the WOPD Code Lookup to check for HCPCS codes that are on the Required Face-to-Face Encounter and Written Order Prior to Delivery List
.