HCPCS code
Orthotics (braces and supports)
CMS description
Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted
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