HCPCS code
Orthotics (braces and supports)
CMS description
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise
In the order to send them
Why these codes
5010 has no orthotics code; payers answer braces under DME, some under prosthetic devices.
If a payer returns nothing
Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.
Sources
CMS HCPCS Level II descriptor; X12 HIPAA 5010 service type code definitions; VerifyTX billing practice