MultiSpecialty RoundUp: Orthopedics

Why This Topic Matters

The update affects whether certain orthopedic support items are treated as covered or non-covered under Medicare and how claims must be reported. Practices that bill these supplies need to recognize the policy change, documentation expectations, and the billing distinctions discussed in the article.

Article Sections

1. Elastic support DME now requires ABN

   Explains the Medicare coverage update affecting elastic support orthoses and the shift toward use of an ABN. Covers the broad types of supplies impacted and the organizations issuing the guidance.

2. DME not affected

   Describes the general category of spinal garments that remain outside the affected elastic-support grouping. Focuses on how the article distinguishes between broad material and structural categories.

3. Modifiers necessary

   Summarizes the reporting topic involving modifier use for spinal orthoses billing under Medicare. Also notes the claim-processing issue discussed for omitted modifiers and the separate treatment of related orthotic items.