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OIG Work Plan Update – Off the Shelf Orthotics

OIG Work Plan Update – Off the Shelf Orthotics January 16, 2018

The OIG has updated its Work Plan today to include Medicare claims in which providers bill for off-the-shelf orthotics under HCPCS codes L1833 (knee orthosis), L0648 and L0650 (lumbar-sacral orthosis).  Since 2014, claims billed for these devices have increased by 97% and charges by 116%.  The OIG will conduct audits to determine whether the records contain appropriate medical necessity documentation.  They will also analyze billing trends and specifically look at whether these orthotic devices are being supplied without an encounter from the referring physician within 12 months of billing.

Additional information regarding the work plan is available at: https://oig.hhs.gov/reports-and-publications/workplan/updates.asp

We recommend providers review the Work Plan updates monthly and conduct proactive audits of the applicable areas identified in the Work Plan.

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