Part B Insider (Multispecialty) Coding Alert

Published on Tue Feb 10, 2004 PDF

New HCPCS Codes for therapeutic shoes will take effect April 1, and so will edit changes that make sure Medicare pays only for the approved number of shoes and inserts. Shoe codes K0628 and K0629 will replace A5509 and A5511 on April 1, and K0628 and K0629 will be added to the edits that monitor how many shoes Medicare pays for in a calendar year, the Centers for Medicare & Medicaid Services says in Jan. 23 Transmittal No. 44, a correction to an earlier transmittal.

Existing policy limits Medicare coverage to no more than one pair of custom-molded shoes and two additional pairs of inserts or no more than one pair of depth shoes and three pairs of inserts, CMS explains in the transmittal. The change merely adds new codes to the edit, it doesn't change existing coverage for the shoes and inserts, CMS says.