On this episode of The O&P Check-in: an SPS Podcast, we spoke with Curt Bertram, CPO, FAAOP, Senior Manager of Clinical Affairs at O&P Insight, to learn more about a recent HCPCS code change and its impact on your clinical practice.
The following includes an excerpt from our conversation, edited for length and clarity. Click here to listen to the full interview.
The O&P Check-in: an SPS Podcast unpacks trends and stories from the tight-knit community of O&P professionals. From patient care to technology, best practices, and regulations, this podcast features topics that help you stay current.
Can you give us some background on CMS’s new HCPCS code and how it should be applied?
The new HCPCS code, L2006, has been around since 2019 and has not been associated with the fee schedule. So, it's not brand new, but there has been a lot of new technology fitting into that code. We refer to it as "innovative technology." Because there wasn't a fee schedule attached to it, there has been some hesitation in using it. Recently, the fee schedule has been attached to this code. It has a descriptor, the fee schedule, and some coding guidance from Medicare.
What are the appropriate use cases for this code?
This code is “innovative technology,” so it offers microprocessor technology to patients with weaknesses or deformities. It allows for a lot more inclusivity within this innovative technology. For example, the C-Brace is essentially a “C-Leg” for a KAFO. What I mean by that is that it’s a hydraulic cylinder that uses microprocessor technology to actuate the cylinder at the appropriate phase of the gait cycle. It never locks and provides resistance to that motion in extension or flexion. Newer technology that is recent to this code is the Agilik. It’s a powered technology that allows resistance and assistance to range of motion at the knee throughout the gait cycle. The way this particular code is written allows both of these products to be included under the same code.
What patients would qualify for this code?
The Agilik is for ambulatory patients. It still falls under the AFO/KAFO LCD, meaning the patient has to have a weakness and/or deformity. It’s not for patients playing sports or aggressively using the device. It’s for patients with knee instability in the sagittal plane. For example, take a pediatric patient with cerebral palsy who has a crouch gait or an adult who has had a stroke. The Agilik is designed to assist in a more upright gait, conserve energy, and train into a better gait pattern. It's with that neurological patient that we’re finding success with this type of technology.
To hear the entire conversation, click here:
Learn more about Curt and his work at O&P Insight.
