Orthotics Management and Training Code Changes

The following changes to the orthotic and prosthetic management codes will be effective as of January 1, 2018:

• Both 97760 and 97761 are revised so that they can only be used for the initial encounter. The new descriptions are:

o 97760 (Orthotic(s) management and training (including assessment and fitting when not otherwise reported), upper extremity(ies), lower extremity(ies) and/ or trunk, initial orthotic(s) encounter, each 15 minutes)

o 97761 (Prosthetic(s) training, upper and/or lower extremity(ies), initial prosthetic(s) encounter, each 15 minutes)

• New CPT 97763 is added and should be used for all other orthotic and/or prosthetic services for an established patient that occur during a subsequent encounter.

o The description of 97763 is: (Orthotic(s)/prosthetic(s) management and/or training, upper extremity(ies), lower extremity(ies), and/or trunk, subsequent orthotic(s)/prosthetic(s) encounter, each 15 minutes)

• 97762 is deleted and should not be used for dates of service after 2017

Please keep in mind that these changes do not affect use of the L codes. If you are billing and getting paid for the assessment, fabrication and fitting of a custom orthotic using the L codes, you should continue to do because the payment is almost always much higher than for 97760. Also, even if you charge for a custom orthotic using an L code, you can charge for training using 97760 or 97763.

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