CMS is reviewing a small percentage of products that may have been inappropriately classified as OTS braces.
Manufacturers submit product information to the Pricing, Data Analysis, and Coding (PDAC) contractor through a Code Verification Review (CVR) application. PDAC uses this information to develop the Product Classification List (PCL).
In preparation for phasing in the Remote Item Delivery Competitive Bidding Program for OTS back, knee, and upper extremity braces, CMS has been reviewing the products on the PCL and has determined that a small percentage of products may have been inappropriately classified as OTS braces. CMS expects to announce the results of this review soon. CMS may remove some products from certain HCPCS Level II codes for OTS back, knee, and upper extremity braces. However, CMS doesn't anticipate that this will result in removing any of the HCPCS Level II codes that have been determined to be included in the OTS back, knee, and upper extremity brace product categories.
CMS also encourages suppliers and other interested parties to engage with the PDAC directly on any particular product and the PCL.
Suppliers should monitor the PDAC website for updates. To get notified as soon as any guidance is published, subscribe for CBIC email updates.