2025 HCPCS code L1833

Prefabricated, off-the-shelf, adjustable unicentric or polycentric knee joint orthosis, providing rigid support.

Prior authorization and a face-to-face encounter are no longer required for this code as of August 12, 2024.

Medical necessity for L1833 is established by documenting a condition that requires stabilization and controlled range of motion of the knee joint, such as postoperative rehabilitation, ligament injury, or instability.The documentation should support the need for this specific type of orthosis rather than a less supportive or non-adjustable option.

This orthosis is typically prescribed and fitted by healthcare professionals such as orthotists, prosthetists, or physical therapists. They assess the patient's needs, select the appropriate orthosis, and ensure proper fit and adjustment for optimal function and support.They also educate the patient on proper use and care of the device.

IMPORTANT L1832 (custom fitted)

In simple words: This is a pre-made, adjustable knee brace available off-the-shelf. It helps support and stabilize the knee after surgery or injury.It has hinges that allow for controlled movement and can be adjusted to fit the patient. It is designed for those who can put weight on their knee and walk.

This code represents a prefabricated, off-the-shelf, adjustable knee orthosis, featuring either a unicentric or polycentric joint, and designed to provide rigid support. It is used to control knee movement medially, laterally, and rotationally.The orthosis is adjustable for flexion and extension, and is suitable for patients who can bear weight and walk, typically used in early postoperative rehabilitation after knee surgery.

Example 1: A patient undergoes ACL reconstruction surgery and requires a knee orthosis to provide support and control range of motion during the early postoperative rehabilitation period., A patient with a knee instability due to a ligament injury uses this orthosis to stabilize the knee and prevent further injury during activities., A patient with osteoarthritis uses this orthosis to provide support and reduce pain during weight-bearing activities.

Documentation should include the diagnosis necessitating the orthosis, the type of orthosis provided (L1833), the medical necessity for its use, and any adjustments made for proper fit.The patient's ability to bear weight and ambulate should also be documented.

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