Action Needed--CMS Plans to Eliminate HCPCS Code L5669
Walter Gorski
Description
Collection
Title:
Action Needed--CMS Plans to Eliminate HCPCS Code L5669
Creator:
Walter Gorski
Date:
12/4/2001
Text:
***IMMEDIATE ACTION NEEDED***
CMS Ignores Liner Issue--Plans to Eliminate HCPCS Code L5669
December 4, 2001
The Centers for Medicare and Medicaid Services (CMS) have rejected the
American Orthotic & Prosthetic Association's (AOPA) request to reinstate
HCPCS code L5669 (Addition to lower extremity, below knee/above knee, socket
insert, suction suspension without locking mechanism). CMS had proposed
deleting this code when it issued its HCPCS code changes for 2002. The
elimination of this code will become effective on January 1, 2002 if CMS
does not reverse its decision.
In their response to AOPA, CMS reaffirmed its decision to crosswalk L5669 to
the old gel liner codes: (L5660, L5662-L5664). The reasons for this
decision, CMS stated, were two-fold:
* there is nothing in the descriptor [of the old gel liner
codes] to prevent these codes from describing the same products as L5669;
and
* Several manufacturers currently recommend use of codes
L5660-L5664 for their silicone suspension products in their catalogs and web
sites.
If Medicare carries out its plan to delete L5669, this decision will have a
serious negative impact on the care of lower limb amputees since the O&P
field will be forced to go back to earlier, less satisfactory technology.
ACTION NEEDED:
AOPA is asking that members of the O&P list serve write Ms. Kaye Riley,
HCPCS coordinator, as well as your DMERC Medical Director and the SADMERC
Medical Director, to request that L5669 be retained. (See below for contact
information.) We, as a profession, need to make clear to Medicare the
inappropriateness of their decision and the depth of the field's concern
with the impact this change will have on patient care.
Please take the time to send these letters today! We also ask that you fax
a copy of your letter to the American Orthotic & Prosthetic Association at
(703) 836-0838, to make sure AOPA knows how many protest letters have been
sent. If you have questions regarding this action alert, please respond to
Walter Gorski, AOPA manager of legislative affairs, at <Email Address Redacted>
<mailto:<Email Address Redacted>>
As you draft your letter, please consider discussing the following points:
* The use of the soft roll-on gel liners for lower limb
amputees is currently the industry standard and the most commonly accepted
method of practice for most such patients.
* L5669 was intended to represent these liners; L5660,
L5662-L5664 were not intended to cover these liners.
* L5660, L5662-L5664 represent older technology that usually involves
two pieces of leather sandwiched around silicone, which is not comparable to
the soft roll-on gel liners most commonly used today.
* Deletion of L5669 will mean that patient care will suffer,
since the field will be forced to go back to earlier, less satisfactory
technology. (You should describe what may happen to patients as a result of
taking them out of roll-on gel liners and putting them back in the older
type liner.)
* For these reasons, L5669 must not be deleted.
Contact Information:
CMS:
Ms. C. Kaye Riley
HCPCS Coordinator
Centers for Medicare & Medicare Services
C5-08-27
7500 Security Boulevard
Baltimore, MD 21244-1850
SADMERC:
Michael Nelson, M.D.
Medical Director, SADMERC
17 Technology Circle
Columbia, SC 29203
DMERC Medical Directors:
Region A
Paul J. Hughes, M.D.
Medical Director Region A
TriCenturion, LLC
P.O. Box 100282
Columbia, SC 29203-9591
Region B
Adrian Oleck, M.D.
Medical Director Region B
Administar Federal
8115 Knue Road
Indianapolis, IN 46250
Region C
Paul Metzger, M.D.
Medical Director Region C
P.O. Box 100141 (17 Technology Circle)
Columbia, SC 29203
Region D
Robert Hoover, Jr., M.D.
Medical Director Region D
CIGNA Medicare
P.O. Box 690
Nashville, TN 37202
CMS Ignores Liner Issue--Plans to Eliminate HCPCS Code L5669
December 4, 2001
The Centers for Medicare and Medicaid Services (CMS) have rejected the
American Orthotic & Prosthetic Association's (AOPA) request to reinstate
HCPCS code L5669 (Addition to lower extremity, below knee/above knee, socket
insert, suction suspension without locking mechanism). CMS had proposed
deleting this code when it issued its HCPCS code changes for 2002. The
elimination of this code will become effective on January 1, 2002 if CMS
does not reverse its decision.
In their response to AOPA, CMS reaffirmed its decision to crosswalk L5669 to
the old gel liner codes: (L5660, L5662-L5664). The reasons for this
decision, CMS stated, were two-fold:
* there is nothing in the descriptor [of the old gel liner
codes] to prevent these codes from describing the same products as L5669;
and
* Several manufacturers currently recommend use of codes
L5660-L5664 for their silicone suspension products in their catalogs and web
sites.
If Medicare carries out its plan to delete L5669, this decision will have a
serious negative impact on the care of lower limb amputees since the O&P
field will be forced to go back to earlier, less satisfactory technology.
ACTION NEEDED:
AOPA is asking that members of the O&P list serve write Ms. Kaye Riley,
HCPCS coordinator, as well as your DMERC Medical Director and the SADMERC
Medical Director, to request that L5669 be retained. (See below for contact
information.) We, as a profession, need to make clear to Medicare the
inappropriateness of their decision and the depth of the field's concern
with the impact this change will have on patient care.
Please take the time to send these letters today! We also ask that you fax
a copy of your letter to the American Orthotic & Prosthetic Association at
(703) 836-0838, to make sure AOPA knows how many protest letters have been
sent. If you have questions regarding this action alert, please respond to
Walter Gorski, AOPA manager of legislative affairs, at <Email Address Redacted>
<mailto:<Email Address Redacted>>
As you draft your letter, please consider discussing the following points:
* The use of the soft roll-on gel liners for lower limb
amputees is currently the industry standard and the most commonly accepted
method of practice for most such patients.
* L5669 was intended to represent these liners; L5660,
L5662-L5664 were not intended to cover these liners.
* L5660, L5662-L5664 represent older technology that usually involves
two pieces of leather sandwiched around silicone, which is not comparable to
the soft roll-on gel liners most commonly used today.
* Deletion of L5669 will mean that patient care will suffer,
since the field will be forced to go back to earlier, less satisfactory
technology. (You should describe what may happen to patients as a result of
taking them out of roll-on gel liners and putting them back in the older
type liner.)
* For these reasons, L5669 must not be deleted.
Contact Information:
CMS:
Ms. C. Kaye Riley
HCPCS Coordinator
Centers for Medicare & Medicare Services
C5-08-27
7500 Security Boulevard
Baltimore, MD 21244-1850
SADMERC:
Michael Nelson, M.D.
Medical Director, SADMERC
17 Technology Circle
Columbia, SC 29203
DMERC Medical Directors:
Region A
Paul J. Hughes, M.D.
Medical Director Region A
TriCenturion, LLC
P.O. Box 100282
Columbia, SC 29203-9591
Region B
Adrian Oleck, M.D.
Medical Director Region B
Administar Federal
8115 Knue Road
Indianapolis, IN 46250
Region C
Paul Metzger, M.D.
Medical Director Region C
P.O. Box 100141 (17 Technology Circle)
Columbia, SC 29203
Region D
Robert Hoover, Jr., M.D.
Medical Director Region D
CIGNA Medicare
P.O. Box 690
Nashville, TN 37202
Citation
Walter Gorski, “Action Needed--CMS Plans to Eliminate HCPCS Code L5669,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/217663.
