--- title: Medicare Dear Physician Knee Orthoses Letter (July 2022) description: The Centers for Medicare & Medicaid Services (CMS) has released a Dear Physician letter with summary guidance information on Medicare's coverage and documentation requirements for knee orthoses.  image: https://blog.elitemedicalsupply.com/hubfs/Blog%20Post%20Images/Dear%20Physician%20Knee%20Orthoses%20Letter%20July%202022%20(1).png --- [Skip to content](https://blog.elitemedicalsupply.com/medicare-dear-physician-knee-orthoses-letter-july-2022#main-content) # Medicare Dear Physician Knee Orthoses Letter (July 2022) Posted by [Elite Medical Supply of NY](https://blog.elitemedicalsupply.com/author/elite-medical-supply) [![Share on Facebook](https://static.hubspot.com/final/img/common/icons/social/facebook-24x24.png)](http://www.facebook.com/share.php?u=https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Dfacebook) [![Share on LinkedIn](https://static.hubspot.com/final/img/common/icons/social/linkedin-24x24.png)](http://www.linkedin.com/shareArticle?mini=true&url=https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Dlinkedin) [![Share on Twitter](https://static.hubspot.com/final/img/common/icons/social/twitter-24x24.png)](https://twitter.com/intent/tweet?original_referer=https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Dtwitter&url=https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Dtwitter&source=tweetbutton&text=Medicare%20Dear%20Physician%20Knee%20Orthoses%20Letter%20%28July%202022%29) [![Share on Pinterest](https://static.hubspot.com/final/img/common/icons/social/pinterest-24x24.png)](http://pinterest.com/pin/create/button/?url=https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Dpinterest&media=http%3A%2F%2Fcdn1.hubspot.com%2Fhub%2F158015%2F305390_10100548508246879_837195_59275782_6882128_n.jpg) [![Share on Email](https://static.hubspot.com/final/img/common/icons/social/email-24x24.png)](mailto:?subject=Check%20out%20https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Demail%20&body=Check%20out%20https%3A%2F%2Fblog.elitemedicalsupply.com%2Fmedicare-dear-physician-knee-orthoses-letter-july-2022%3Futm_medium%3Dsocial%26utm_source%3Demail) The Centers for Medicare & Medicaid Services (CMS) has released a Dear Physician letter with summary guidance information on Medicare's coverage and documentation requirements for knee orthoses.  According to the July 2022 letter "Knee orthoses have consistently been one of the highest sources of errors in medical reviews performed by the Durable Medical Equipment Medicare Administrative Contractors (DME MACs) and the Comprehensive Error Rate Testing (CERT) contractor." The CMS Dear Physician Knee Orthoses Letter is available using this [link](https://www.cgsmedicare.com/jb/mr/pdf/dear_physician_knee_orthoses.pdf). This letter, and other Dear Physician letters, can be accessed at the following URL: [https://www.cgsmedicare.com/jb/mr/doc_req.html](https://www.cgsmedicare.com/jb/mr/doc_req.html) ### Why is this important? CMS understands the importance of educating providers with guidance on Medicare's coverage and determination requirements for DMEPOS (durable medical equipment, prosthetics, orthotics and supplies). The summary guidance letter describes Medicare's requirements for documenting medical necessity of knee orthoses. Understanding the Medicare knee orthoses coverage and determination requirements, along with the required medical necessity which must be documented, is beneficial to reduce claim denials and rejections. ### ![Dear Physician Knee Orthoses Letter July 2022 (1)](https://blog.elitemedicalsupply.com/hs-fs/hubfs/Blog%20Post%20Images/Dear%20Physician%20Knee%20Orthoses%20Letter%20July%202022%20(1).png?width=1600&name=Dear%20Physician%20Knee%20Orthoses%20Letter%20July%202022%20(1).png) The summary guidance letter also includes information about HCPCS codes that require prior authorization, face-to-face encounter, and written order prior to delivery. We previously wrote about prior authorization in the blog [Prior Authorization Changes for Medicare Off-the-Shelf Knee and Back Braces](https://blog.elitemedicalsupply.com/prior-authorization-changes-for-medicare-off-the-shelf-knee-and-back-braces).   ### HCPCS Coverage Criteria If your office writes for any of the following HCPCS codes you'll want to review the Summary of Coverage Criteria section. | Prefabricated | Custom Fabricated | | --- | --- | | L1810 | L1834 | | L1812 | L1840 | | L1820 | L1844 | | L1830 | L1846 | | L1831 | L1860 | | L1832 |   | | L1833 |   | | L1836 |   | | L1843 |   | | L1845 |   | | L1850 |   | | L1851 |   | | L1852 |   | ### Additional Resources A brief summary of the Knee Orthoses LCD is available by clicking this [link](https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33318). The Knee Orthoses Policy Article is available by clicking this [link](https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=52465). ### We're Here to Help Our Team is ready to answer questions about Medicare coverage for knee orthoses. We have billing and orthoses professionals ready to assist with coverage questions and identifying the proper HCPCS code for your patient's knee orthosis. [Contact ](https://www.elitemedicalsupply.com/contact)us today and take a look at our wide selection of [knee orthoses](https://www.elitemedicalsupply.com/knee-braces). Tags: [Knee Braces](https://blog.elitemedicalsupply.com/tag/knee-braces), [Medical Providers](https://blog.elitemedicalsupply.com/tag/medical-providers) #### Written by [Elite Medical Supply of NY](https://blog.elitemedicalsupply.com/author/elite-medical-supply) ### Related Articles [ ### How to Avoid a Medicare Scam ](https://blog.elitemedicalsupply.com/how-to-avoid-a-medicare-scam) [ ### Does Medicare Provide Coverage For a Knee Brace? ](https://blog.elitemedicalsupply.com/how-to-get-a-knee-brace-covered-by-medicare) [ ### Prior Authorization Changes for Medicare Off-the-Shelf Knee and Back Braces ](https://blog.elitemedicalsupply.com/prior-authorization-changes-for-medicare-off-the-shelf-knee-and-back-braces) ### Braces and Products Covered by Medicare [Browse Products](https://www.elitemedicalsupply.com/products) ### Recent Posts - [*Cervical Brachial Syndrome (Thoracic Outlet Syndrome): What You Need to Know*](https://blog.elitemedicalsupply.com/cervical-brachial-syndrome-thoracic-outlet-syndrome-what-you-need-to-know) - 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[*Medicare Scam (1)*](https://blog.elitemedicalsupply.com/topic/medicare-scam) - [*Muscle Atrophy (1)*](https://blog.elitemedicalsupply.com/topic/muscle-atrophy) - [*PCL (1)*](https://blog.elitemedicalsupply.com/topic/pcl) - [*Patellofemoral Pain Syndrome (1)*](https://blog.elitemedicalsupply.com/topic/patellofemoral-pain-syndrome) - [*TLSO (1)*](https://blog.elitemedicalsupply.com/topic/tlso) - [*Thoracic Outlet Syndrome (1)*](https://blog.elitemedicalsupply.com/topic/thoracic-outlet-syndrome) - [*Ulnar Tendinitis (1)*](https://blog.elitemedicalsupply.com/topic/ulnar-tendinitis) ![](https://www.facebook.com/tr?id=2949718318649932&ev=PageView&noscript=1) ```json { "@context" : "http://www.schema.org", "@type" : "MedicalBusiness", "address" : [ { "@type" : "PostalAddress", "addressLocality" : "West Seneca", "addressRegion" : "NY", "postalCode" : "14224", "streetAddress" : "1900 Ridge Rd #125" }, { "@type" : "PostalAddress", "addressLocality" : "Hendersonville", "addressRegion" : "TN", "name" : "FDA REGISTERED MANUFACTURING FACILITY", "postalCode" : "37075", "streetAddress" : "40 Industrial Park Drive Suite C" } ], "contactPoint" : [ { "@type" : "ContactPoint", "areaServed" : "US", "contactOption" : "TollFree", "contactType" : "customer service", "faxNumber" : "(866) 712-0882", "telephone" : "(866) 712-0881" } ], "description" : "Elite Medical Supply is a Medicare Contract Supplier for back and knee braces. We are contracted to provide Medicare beneficiaries with back and knee braces in most Competitive Bid Areas and accept assignment of Medicare-covered products.", "faxNumber" : "(716) 712-0882", "image" : "https://www.elitemedicalsupply.com/hubfs/Stock%20images/Happy%20old%20couple%20smiling%20in%20a%20park%20on%20a%20sunny%20day.jpeg", "logo" : "https://www.elitemedicalsupply.com/hubfs/Logo%20Files/Elite%20%5Bspine%5D%20Medical%20Supply%20logo%20TRN%20BKGND.png", "makesOffer" : [ "Back Braces", "Knee Braces", "Foot Products", "Ankle Products", "Shoulder Products", "Elbow Products", "Wrist Products", "Bone Growth Stimulators" ], "name" : "Elite Medical Supply of NY", "priceRange" : "-", "telephone" : "866-712-0881", "url" : "https://www.elitemedicalsupply.com/" } ```