Table of content for "Ko double upright pre ots" (HCPCS K0902)
General information on the “K0902” code
HCPCS Code: K0902
Long Description: Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf
Short Description: Ko double upright pre ots
Original information is taken from K0902 page
Pricing indicators
Pricing Indicator Code 1: 38 – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) . Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Cross Reference Code 1: L1852 ;
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): D1F – Prosthetic/Orthotic devices
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 20141001
Code Effective Date: 20170101
Termination Date: 20161231
Action Code: N – No maintenance for this code