Coding: Taking the Mystery Out

Decoding the Future: What You Need to Know About New HCPCS Codes in O&P (B7A) Curt A. Betram, CPO, FAAOP, O&P Insight, LLC; Lesleigh Sisson, CFo, CFm, O&P Insight, LLC Over the last few years, we have seen the addition of several new Level II HPCPCS L-codes related to O&P. This is good news from the HCPCPS Workgroup as they are responding to the industrya??s ask(s) for new L-codes and the recognition of new technology (e.g., 3D printing, MP controlled orthotics, UL Partial Hand Prosthetics, ...). These new code(s) and fee schedule(s) do not come without risks and are not quickly adopted by other payers (i.e., Medicaid, Commercial, MAP, ...). Other payers may maintain E&I denials, non-coverage policies, and/or not reimburse the new code(s) at appropriate rates. It is important for you as a Supplier to push back on these issues. Correct Coding of Upper Limb Prostheses (B7B) Chris Baschuk, MPO, CPO, FAAOP(D), Point Designs Understanding HCPCS coding for upper limb prosthetics is critical for accurate billing, reimbursement, and compliance. This session will provide a comprehensive update on new and existing HCPCS codes for upper limb prostheses, including the recently created partial hand prosthesis codes, the intent decoding module, and upper limb adjustable socket codes. Take a peek behind the curtain of how new codes are established and how that process has evolved over the years.

This course is worth 1.75 business credits. If you attended this session at the 2025 National Assembly, please note you will not receive credit again.