New Options Sports Suggested HCPCS Codes

1 New Options Sports Suggested HCPCS Codes Part Suggested Number Description HCPCS code CEILING FLOOR. K1-F /16" Covered Hinge Knee w/ Universal Felt Buttress & Criss-Cross Fan Patellar Control L1820 $ $ K1-U /16" Covered Hinge Knee w/ Universal Felt Buttress L1820 $ $ K2-U /16" Padded Hinge Knee w/ Covered Multi-Position Ext. Hinges & Universal Felt Buttress L1820 $ $ K4-F /16" Patellar Knee w/ Criss-Cross Fan Patellar Control Straps A4466 Not Available K4-U /16" Patellar Knee w/ Spiral Stays & Universal Felt Buttress A4466 Not Available K8-U " Patellar Knee w/ Spiral Stays & Universal Felt Buttress A4466 Not Available K9 " Knee Sleeve w/ Oval Anterior Pad (Closed Patella) A4466 Not Available K9-CO " Knee Sleeve w/ Oval Anterior Pad & Patellar Cut Out A4466 Not Available K9-COP " Knee Sleeve w/ Patellar Cut Out A4466 Not Available K9-COPS " Knee Sleeve w/ Patellar Cut Out & Spiral Stays A4466 Not Available K9-P " Knee Sleeve (Closed Patella)

2 L2999 Not Available K9-U " Knee Sleeve w/ Oval Anterior Pad & Universal Buttress L2999 Not Available K10-P /16" Perforated Undersleeve For Functional Knee Braces L2850 $ $ K11-U /16" Cartilage Knee w/ Universal Felt Buttress A4466 Not Available NEOPRENE KNEES. K13 " Knee Support w/ Superior Tubular Buttress A4466 Not Available K13-D " Knee Support w/ Covered Tubular Donut Buttress A4466 Not Available K14 " Patellar Knee w/ Superior Tubular Buttress, Straps & Spiral Stays A4466 Not Available K14-D " Patellar Knee w/ Covered Tubular Donut Buttress, Straps & Spiral Stays A4466 Not Available K14-I " Patellar Knee w/ Inferior Tubular Buttress, Straps & Spiral Stays A4466 Not Available K15-L " Patellar Stabilizer w/ Dynamic Lateral J Buttress Pull Panel - Left A4466 Not Available K15-R " Patellar Stabilizer w/ Dynamic Lateral J Buttress Pull Panel - Right A4466 Not Available K16 " UBL Universal Wrap Around Patellar Knee w/ Universal Buttress (Thigh up to 26") A4466 Not Available K16-OS 1/8" UBL Universal Wrap Around Patellar Knee w/ Universal Buttress (Thigh up to 30")

3 A4466 Not Available K18 " Osgood Schlater Knee w/ Shock Absorbing V-Shaped Compression Pad (Patented) A4466 Not Available K27 Arthroscopic Compression Wrap Around Foam Knee A4466 Not Available K32 /16" 13" High Tech Knee w/ HT ROM Hinge (Flex. & Ext.) & Universal Felt Buttress L1832 $ $ K34 " SuperLite Knee w/ Polycentric Low Profile Hinges L1820 $ $ K35* (KTW) Knee Therapy Wrap A4466 Not Available K36 Knee Therapy Wrap w/ SynerGel Cold/Hot Insert Pad A4466 Not Available K37 SynerGel Cold/Hot Insert Pad Only A4466 Not Available K42* 13" NOS Rehab Knee With HT ROM Hinge (Flexion & Extension Control) L1832 $ $ K44 " Dynamic Patellar Stabilizer w/ Shark Skin Pull Buttress, Spiral Stays & Open Pop Univ. L or R (Pat. Pend.) A4466 Not Available K56 /16" 17" High Tech Knee w/ HT ROM Hinge (Flexion & Extension Control) Hinges L1832 $ $ K57 " Swedish Knee w/ Tubular Universal (left or right) Crescent Pull Buttress & Covered Ext.

4 Hinges L1850 $ $ K64 /16" Knee Mate Wrap Around Knee w/ LD Hinges L1820 $ $ K64-H /16" Knee Mate Wrap Around Knee w/ Covered Multi-Position Ext. Hinges L1820 $ $ K64-HT /16" Knee Mate Wrap Around Knee w/ HT ROM Hinge (Flexion & Extension Control) L1832 $ $ New Options Sports has provided these Suggested HCPCS Codes for billing purposes only. New Options Sports assumes no liability in the use of these Codes . Ceiling and Floor amounts from as listed on 4/20/11 revised 4/20/11. New Options Sports Suggested HCPCS Codes Part Suggested Number Description HCPCS code CEILING FLOOR. K64-LP /16" Knee Mate Wrap Around Knee w/ Low Profile Polycentric Hyperextension Hinges at 5 L1820 $ $ K64-S /16" Knee Mate Wrap Around Knee w/ Medial & Lateral Spiral Stays A4466 Not Available K65 /16" 17" Knee Mate Wrap Around Knee w/ HT ROM Hinge (Flexion & Extension Control) L1832 $ $ K67 /16" 13" Hybrid Knee w/ Ant.

5 Top Velcro Closure & Closed Bottom & covered Adj. LD Hinges (Pat. Pend.) L1820 $ $ K67-H /16" 13" Hybrid Knee w/ Ant. Top Velcro Closure & Closed Bottom & Adj. Multi-Position Ext. Hinges (Pat. Pend.) L1820 $ $ K67-HT /16" 13" Hybrid Knee w/ Ant. Top Velcro Closure & Closed Bottom & Adj. HT ROM Hinge (Flex. & Ext.) (Pat. Pend.) L1832 $ $ K67-LP /16" 13" Hybrid Knee w/ Ant. Top Velcro Closure & Closed Bottom w/ #6 LP Polycentric Hinges at 5 (Pat. Pend.) L1820 $ $ K67-S /16" 13" Hybrid Knee w/ Ant. Top Velcro Closure & Closed Bottom & Medial & Lateral Spiral Stays (Pat Pend.) A4466 Not Available NEOPRENE KNEES. K68-HT /16" 17" Hybrid Knee w/ Ant. Top Velcro Closure & Closed Bottom & Adj. HT ROM Hinge (Flex. & Ext.) (Pat. Pend.) L1832 $ $ K72 17" NOS Rehab Knee With HT ROM Hinge (Flexion & Extension Control) L1832 $ $ K88-U 1/8" Hinged Patella Knee Stabilizer with Universal Felt, Horseshoe Buttress L1820 $ $ K114-D 1/8" Hinged Patella Knee Stabilizer with Adjustable, Enclosed Tubular Buttress L1820 $ $ K115-L Hinged Dynamic Patella Stabilizer with J Buttress - Left L1820 $ $ K115-R Hinged Dynamic Patella Stabilizer with J Buttress - Right L1820 $ $ K191 1/8" UBL Universal Wrap Around Knee w/ Universal Felt Buttress and Sharkskin Grip Strips under Spiral Stays L1820 $ $ K194 " UBL Universal Wrap Around Knee w/ Patellar Pull Buttress & Spiral Stays (Thigh up to 26") A4466 Not Available K194-OS 1/8" UBL Universal Wrap Around Knee w/ Patellar Pull Buttress & Spiral Stays (Thigh up to 30")

6 A4466 Not Available K195 " KNS UBL "The Winner" Knee Strap w/ Moldable Insert L2999 Not Available K195-M " KNS-M UBL "The Winner" Knee Strap w/ Moldable Magnetic Insert L2999 Not Available K196 /16" Sharktrak UBL Universal Wrap Around w/ Patellar Pull Buttress & Spiral Stays (Pat. Pend.) A4466 Not Available K199 The Spooner Patella Stabilizing Strapping System -addition to non-custom lower extremity orthosis L2795 $ $ K199 The Spooner Patella Stabilizing Strapping System -addition to custom lower extremity orthosis L2800 $ $ K404 /16" Patellar Knee w/ Positive Control Bottom Strap (Patented) A4466 Not Available K770 20" Universal, Drop Lock Rehab Knee - black foam material L1831 $ $ W1-L " 6" Neoprene Action Wristlet Support w/ Circumferential Strap - Left L3908 $ $ NEOPRENE WRISTS. W1-R " 6" Neoprene Action Wristlet Support w/ Circumferential Strap - Right L3908 $ $ W2-L " 8" Neoprene Action Wristlet Support w/ Circumferential Strap - Left L3908 $ $ W2-R " 8" Neoprene Action Wristlet Support w/ Circumferential Strap - Right L3908 $ $ W6 " Neoprene Universal Wrist Wrap w/ Abducted Thumb A4466 Not Available W7 " UBL Universal Wrist Wrap w/ Abducted Thumb & Malleable Splint A4466 Not Available W11 " Neoprene Thumb Splint Universal L or R A4466 Not Available W12-L " 6" Neoprene Wrist Support w/ Velcro Adj.

7 Palm Closure - Left L3908 $ $ W12-R " 6" Neoprene Wrist Support w/ Velcro Adj. Palm Closure - Right L3908 $ $ W13-L " 8" Neoprene Wrist Support w/ Velcro Adj. Palm Closure - Left L3908 $ $ W13-R " 8" Neoprene Wrist Support w/ Velcro Adj. Palm Closure - Right L3908 $ $ New Options Sports has provided these Suggested HCPCS Codes for billing purposes only. New Options Sports assumes no liability in the use of these Codes . Ceiling and Floor amounts from as listed on 4/20/11 revised 4/20/11. New Options Sports Suggested HCPCS Codes Part Suggested Number Description HCPCS code CEILING FLOOR. W18-L " 6" Neoprene Wrist Support w/ Velcro Adj. Circumferential Strap - Left L3908 $ $ W18-R " 6" Neoprene Wrist Support w/ Velcro Adj. Circumferential Strap - Right L3908 $ $ W20-L " 6" Universal UBL Wristlet w/ Velcro Adj. Palm Closure - Left L3908 $ $ W20-R " 6" Universal UBL Wristlet w/ Velcro Adj.

8 Palm Closure - Right L3908 $ $ W22 " Neoprene Universal Ambidextrous Wrist & Thumb Support w/ Strap L3908 $ $ W28-L " 8" Universal UBL Wristlet w/ Velcro Adj. Palm Closure - Left L3908 $ $ W28-R " 8" Universal UBL Wristlet w/ Velcro Adj. Palm Closure - Right L3908 $ $ W31 " Neoprene Wrist Wrap A4466 Not Available NEOPRENE WRISTS. W36 Neoprene wrist wrap with two 1" loop and lock compression straps A4466 Not Available W38-L Komfort wrist with abducted thumb (adjust stays for proper fit) - Left L3908 $ $ W38-R Komfort wrist with abducted thumb (adjust stays for proper fit) - Right L3908 $ $ W40 Tunnel Tech Carpal Tunnel Wrist Brace (PATENTED) A4466 Not Available W47-L " 6" Neoprene Wristlet w/ Abducted Thumb & Strap - Left L3908 $ $ W47-R " 6" Neoprene Wristlet w/ Abducted Thumb & Strap - Right L3908 $ $ W56-L " Neoprene Pull-On Thumb & Wrist Support - Left A4466 Not Available W56-R " Neoprene Pull-On Thumb & Wrist Support - Right A4466 Not Available W57-L " Neoprene Thumb & Wrist Support /w Velcro Closure - Left A4466 Not Available W57-R " Neoprene Thumb & Wrist Support /w Velcro Closure - Right A4466 Not Available W59 " VelPlush Universal Boomerang Wrist Wrap A4466 Not Available W60-L " 6" VelPlush Universal Wrist Wrap w/ Strap & Removable Splint - Left L3908 $ $ W60-R " 6" VelPlush Universal Wrist Wrap w/ Strap & Removable Splint - Right L3908 $ $ W68-L " 8" VelPlush Universal Wrist Wrap w/ Strap & Removable Splint - Left L3908 $ $ W68-R " 8" VelPlush Universal Wrist Wrap w/ Strap & Removable

9 Splint - Right L3908 $ $ W77-L Universal Wrist Lacing Orthosis - Left L3908 $ $ W77-R Universal Wrist Lacing Orthosis - Right L3908 $ $ E1 " Neoprene Elbow Sleeve A4466 Not Available NEOPRENE ELBOWS. E2 " Neoprene Tennis Elbow Support w/ Distal Strap A4466 Not Available E3 " Neoprene Universal Tennis Elbow Strap L3999 Not Available E4 " Neoprene Tennis Elbow Strap w/ Covered 1/4" Felt Pad L3999 Not Available E5 " Neoprene Tennis Elbow Strap w/ Covered Velfoam Pad L3999 Not Available E6 " Neoprene Tennis Elbow Strap w/ Covered SynerGel Pad L3999 Not Available E7 /16" Neoprene Elbow Sleeve w/ Criss-Cross Hyperextension Straps A4466 Not Available E9 " Neoprene Elbow Support w/ Covered Multi-Position Locking Ext. Hinges L3710 $ $ E9-HT " Neoprene Elbow Support w/ HT ROM Locking Hinge (Flex. & Ext.) L3760 $ $ E12 " Neoprene Elbow Sleeve w/ Covered LD Hinges & Criss-Cross Hyperextension Straps L3710 $ $ E15 " Neoprene Hyperextension Elbow w/ Polycentric Hinges & "E-Z-E" Bicep Closure (Pat.)

10 Pend.) L3710 $ $ New Options Sports has provided these Suggested HCPCS Codes for billing purposes only. New Options Sports assumes no liability in the use of these Codes . Ceiling and Floor amounts from as listed on 4/20/11 revised 4/20/11. New Options Sports Suggested HCPCS Codes Part Suggested Number Description HCPCS code CEILING FLOOR. E16 " Neoprene Cubital Tunnel Support w/ Anterior Velcro Closures A4466 Not Available NEOPRENE. ELBOWS. E18 " Gripster Elbow Sleeve w/ Shock Absorbing Pad A4466 Not Available ENS " UBL "The Winner" Elbow Strap w/ Moldable Insert L3999 Not Available ENS-M " UBL "The Winner" Elbow Strap w/ Moldable Magnetic Insert L3999 Not Available A1 Cooper I - /16" Ankle Stabilizer Brace w/ Top Circumferential Strap Fits L or R (Patented) L1902 $ $ NEOPRENE. A2 " Ankle Support w/ Zipper A4466 Not Available ANKLES. A7 " Ankle Support w/ Anterior Velcro Closure & Closed Bottom A4466 Not Available A20 UXO Ankle System L1906 $ $ A30 5 in 1 Foot and Ankle Orthosis (Treats 5 Diagnosis For Foot and Ankle) (Patented) L1902, L3480 $ , $ $ , $ A50 Cooper II - /16" Ankle Stabilizer w/ Spiral Stay, Medial & Lateral Non Stretch Stability Straps Fits L or R (Patented) L1906 $ $ C1 " Calf Support L2999 Not Available C2 " Shin Splint Support L2999 Not Available DC2 " Digit Covers - 1 Pair (Men's Shoe Size 4-9) L2999 Not Available Sports MEDICAL.