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March 4, 2022

Knee Orthoses and Lumbar Sacral Orthoses (LSOs) to Be Included in Prior Authorization

CMS has announced the selection of certain knee orthoses and LSOs to be subject to required prior authorization, beginning April 13, 2022, in certain states.

CMS selected the following 5 HCPCS codes:

  • LSOs: L0648 and L0650 
  • Knee Orthoses: L1832, L1833, and L1851

Implementation of this requirement will be completed in 3 phases:

  • Phase 1 begins April 13, 2022, in New York, Illinois, Florida, and California.
  • Phase 2 begins July 12, 2022, in Maryland, Pennsylvania, New Jersey Michigan, Ohio, Kentucky, Texas, North Carolina, Georgia, Missouri, Arizona, and Washington.
  • Phase 3 begins October 10, 2022, in all remaining states and territories not included in phase 1 or phase 2.

CGS is preparing to schedule additional education and will publish more instructions as we near the implementation date. Read the electronic mailing list, 2022 DME MAC Jurisdiction B News, and Prior Authorization webpage, to stay updated.

Learn more about these requirements on the CMS website:

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