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What is the CPT Code for a Custom-Fit Knee Brace with Single Upright Design?

Custom-Fit Knee Brace with Single Upright Design HCPCS Code L1843

To bill for custom-fit knee braces with a single upright design, you'll need to use HCPCS Level II codes, which are designed for healthcare products and services that fall outside the CPT system. All bracing and orthotic devices are categorized under the "L" series of HCPCS codes.

HCPCS Code:

L1843

Definition:

Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

This code applies to custom-fit knee braces with a single upright design and adjustable flexion and extension joints (unicentric or polycentric). These braces provide medial-lateral and rotational control, with optional varus/valgus adjustments to align and stabilize the knee. Prefabricated and professionally adjusted by healthcare providers, these braces ensure precise fit, effective stabilization, and Medicare compliance.

Clinical Use Cases for L1843 Custom-Fit Knee Braces

Post-Surgical Recovery

Provides advanced stabilization and controlled motion for patients recovering from complex knee surgeries, such as ligament reconstruction or total knee replacement.

Severe Knee Instability

Offers medial-lateral, rotational, and varus/valgus control for patients with severe knee instability due to ligament damage or chronic conditions.

Knee Injury Rehabilitation

Supports controlled knee motion and alignment during rehabilitation, reducing the risk of further injury and aiding recovery.

Why Healthcare Providers Choose Brace Direct

  • Customer Service at Brace Direct is efficient, knowledgeable, and helpful.

    Comprehensive Product Selection

    Our extensive range of PDAC-approved braces ensures you'll find the perfect solution for every patient's unique needs. From off-the-shelf options to specialized supports, we provide high-quality products that meet stringent medical standards.

  • Streamlined Ordering Process

    Our user-friendly online platform allows for quick and efficient product selection. Search by specific codes, patient conditions, or product features to find exactly what you need with minimal effort.

  • Expert Clinical Support

    Access a wealth of educational resources including detailed fitting guides, instructional videos, and direct support from our team of bracing specialists. We're committed to supporting healthcare providers in delivering optimal patient care.

Cost-Effective Solutions

Benefit from competitive pricing, volume discounts, and our Provider Discount Program. We help you manage costs without compromising on the quality of patient care and support.

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Provider Discount Program

Save on wholesale orders and access exclusive volume discounts for your practice. Our program makes it easy to stock high-quality, PDAC-approved braces at competitive prices, ensuring your patients receive the best care while keeping your costs low.

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Become an Affiliate

Earn commissions by referring patients to trusted, high-quality braces. Our Affiliate Program offers a seamless way to recommend PDAC-approved products to your patients while creating an additional revenue stream for your practice.

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Explore Our L1843 PDAC Approved Custom-Fit Knee Braces with Single Upright Design

Deliver superior stabilization for your patients with our PDAC Approved custom-fit knee braces. Designed for professional adjustment, these braces ensure precise support and Medicare compliance for a variety of knee conditions.

View Custom-Fit Knee Brace Collection

Frequently Asked Questions

How can I ensure correct billing for DME (Durable Medical Equipment)? +

To bill for DME, you’ll need proper documentation, including patient diagnosis, medical necessity, and a detailed prescription. Be sure to use the appropriate modifiers (e.g., KX, RT, LT) and maintain compliance with Medicare guidelines.

Why doesn't Brace Direct work with insurance or Medicare? +

Brace Direct follows a direct-to-consumer model to offer affordable prices, upfront pricing transparency, and faster access to braces without the delays and complexities of insurance or Medicare billing. Many products are FSA and HSA eligible for added convenience.
Direct-to-Consumer Medical Braces & Supports: No Insurance Hassles

How does Brace Direct support healthcare providers? +

We offer an extensive range of PDAC-approved products, educational resources, and a user-friendly ordering platform. Additionally, our Provider Discount Program helps practices manage costs while delivering high-quality care.

What does PDAC approval mean, and why is it important? +

PDAC (Pricing, Data Analysis, and Coding) approval ensures that a brace meets Medicare’s strict requirements for quality, design, and function. Using PDAC-approved products simplifies reimbursement processes and helps avoid claim denials.

Where can I learn more about Medicare's requirements for braces and billing? +

For more details on Medicare’s coding and reimbursement guidelines for orthotics, visit the official Medicare website below.
Medicare's DME Coverage

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