2025 HCPCS Code K0901
Knee orthosis (ko), 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, off-the-shelf
TAGS: adjustable joint orthosis extension flexion thigh rotation single| Notice | HCPCS K0901 terminated on December 31, 2016. |
| Short Description | Ko single upright pre ots |
| HCPCS Action Code | N - No maintenance for this code |
| HCPCS Coverage Code | C - Carrier judgment |
| HCPCS Code Added Date | October 01, 2014 |
| HCPCS Action Effective Date | January 01, 2017 |
| HCPCS Pricing Indicator Code | 38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| HCPCS Type Of Service Code | P - Lump sum purchase of DME, prosthetics, orthotics |
| HCPCS Multiple Pricing Indicator Code | A - Not applicable as HCPCS priced under one methodology |
| HCPCS Anesthesia Base Unit Quantity | 0 |
| HCPCS Coverage Issues Manual Reference Section Number |
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