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Medicare HCPCS Coding Verification Letters, please click on the product item number below to view the letter.


Note
:
Select codes may have changed, or “cross walked” to a revised code
 since the original issue date of these letters. Claim submissions bearing
 the original code should be honored for payment. For an up-to-date listing
 of original and “cross walked” codes for SAI Therapeutic Brands please
 follow this link:

                http://www3.palmettogba.com/dmecs/jsp/index.jsp
 Click on Search for Codes or Fees; under Manufacturer/Distributor type in
 Surgical Appliance, then select GO.
 

 Wrist Supports
 C-128 Neoprene Wraparound Wrist Support
 C-303 Neoprene Wrist-Thumb Support
 C-304 Neoprene Cock-up Wrist Support
 C-305 Neoprene Thumb Splint
 2073 Molded Plastic Thumb Splint
 2081 Exolite Low-profile Wrist Brace
 2082 Lightweight 6" Wrist Splint
 2083 Lightweight Breathable 8" Wrist Splint
 2087 Lightweight Breathable 8" Wrist-Thumb Splint
 2360 SoftFit Suede Finish Wrist Brace
 2362 Cock-up Wrist Splint
 2364 Professional's Choice Cock-up Wrist Splint
 2389 Occupational Wrist Support
 2418 Elastic Pullover Wrist Support

 Cervical Supports
 2394 OTC Soft Foam Cervical Collar

 Back Supports
 464-GHS Lumbosacral Orthosis
 464-VHS Lumbosacral Orthosis
 465-HS Lumbosacral Orthosis
 465-VHS Lumbosacral Orthosis
 486-HS Thoracolumbar Orthosis
 957 Knight-Taylor Thoracolumbar Orthosis
 962 Chair-Back Lumbosacral Orthosis
 2884 Lightweight Lumbosacral Support
 2890 Lumbosacral Support w/ Abdominal Uplift
 2892 Lumbosacral Orthosis
 2893 Lumbosacral Support w/ Abdominal Uplift
 2895 LumboTEK Elastic Lumbosacral Support

 Knee Supports
 C-141 Champion Neoprene Knee Support w/ Oval Pad
 C-142 Champion Neoprene Knee Support w/ Hor-Shu Pad
 C-143 Champion Neoprene Knee Support w/ Pad & Hinged Bars
 C-144 Champion Neoprene Knee Support w/ Pad & Spiral Stays
 C-306 Champion Neoprene Knee Support w/ Open Patella
 C-308 Champion Neoprene Knee Stabilizer w/ Spiral Stays
 C-309 Champion Neoprene Knee Support w/ Stabilizer Pad
 C-310 Champion Neoprene Knee Stabilizer w/ Hinged Bars
 C-311 Champion Neoprene Knee Stabilizer Wrap w/ Hinged Bars
 C-312 Champion Neoprene Knee Stabilizer Wrap w/ Hinged Stays
 C-314 Champion Neoprene Knee Wrap w/ Stabilizer Pad

 2416 OTC Elastic Pullover Knee Support
 2422 OTC KNEED-IT Therapeutic Knee Guard
 2425 OTC Knee Support w/ Viscoelastic Insert
 2541 Orthotex Knee Stabilizer w/ Spiral Stays
 2542 Orthotex Knee Stabilizer Wrap w/ Spiral Stays
 2543 Orthotex Knee Stabilizer w/ Hinged Bars
 2544 Orthotex Knee Stabilizer Wrap w/ Hinged Bars
 2545 OTC Knee Support w/ Front Opening, Pressure Pads
 2546 Orthotex Knee Support w/ Stabilizer Pads
 2553-P OTC Knee Support w/ Spiral Stays, Open Patella
 2554 OTC Knee Brace w/ Hinged Bars
 2555 OTC Knee Support w/ Pressure Pads, Open Patella
 2555-V OTC Knee Support w/ Expansion Panel, Pressure Pads

 Ankle Supports
 2092 OTC Ankle Stirrup Brace w/ Airform Pads
 2093 OTC Ankle Stirrup w/ Honeycomb Pads
 2371 OTC High-performance Ankle Brace
 2372 OTC Canvas Ankle Splint
 2375 OTC Ankle Stabilizer w/ Heel Locking Straps
 2376 OTC Ankle Stabilizer w/ Criss-cross Strap & Molded Exoskeleton
 2417 OTC Firm Elastic Pullover Ankle Support
 2426 OTC Ankle Support w/ Viscoelastic Insert
 2560 OTC Ankle Support w/ Spiral Stays

 Home Medical Equipment
 210404 PCP Adjustable Folding Cane w/ Orthopedic Handle
 5595-BL PCP Low-profile, Large Base Quad Cane
 6230 PCP Ring Cushion - Inflatable
 6233 PCP Ring Cushion - Carved Foam
 7002 PCP Adjustable Shower Chair w/o Back
 7013 PCP Molded Raised Toilet Seat
 7255 PCP Coated Tub Bar

 


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