ORTHOMERICA® Receives New HCPCS Code for Cranial Remolding Orthoses

Orthomerica is pleased to announce that we have received notification that the HCPCS Panel has approved a new HCPCS code for cranial remolding orthoses, and the code will be available for use as early as October 1, 2002.

The HCPCS Alpha-Numeric Panel has assigned the following new permanent HCPCS Level II code and nomenclature for cranial remolding orthoses:

S1040 Cranial Remolding Orthosis, rigid, with soft interface material, custom fabricated (Includes fitting and adjustment)

“S” codes are HCPCS Level II codes that are established based on third party payer and Medicaid program needs to identify a healthcare product and/or service. Since cranial remolding orthoses are not billed to Medicare, it was decided that an S-code would be the most appropriate means to accurately identify the cranial remolding orthosis for Medicaid State Agencies and private sector third party payers.

Development of medical policy, coverage and reimbursement for S1040 will be left to the individual insurance carriers. It is anticipated that use and recognition of S1040 will expedite claims processing, and also eliminate problems previously associated with billing “not-otherwise-specified” (NOS) codes.

Orthomerica agrees with AOPA’s recommendation that O&P providers continue to bill L-1499 for cranial remolding orthoses used to treat deformational plagiocephaly and brachycephaly for non-Medicare patients until CMS implements S1040 later this year.

For more information, please contact Bill Gustavson, Director of Marketing for Orthomerica Products, Inc. at 407.290.6592 x 219.