CMS lifts prior authorization for some orthopedic braces

Carly Behm -  

CMS has suspended prior authorization requirements for some orthoses products under limited circumstances, according to an Aug. 9 update.

The requirements were lifted because the two-day expedited review may delay care and put a patient's health at risk, according to CMS' website.

The move will affect:

1. Codes L0648, L0650, L1832, L1833, and L1851 billed with modifier ST, saying the item was furnished "urgently."

2. Codes L0648, L0650, L1833, and L1851 billed with "modifiers KV, J5, or J4, by suppliers furnishing these items under a competitive bidding program exception."

Full details about the policy updates can be read here.

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