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Wiki Medicare Same and similar for Orthotic brace

Thread starter SSShaw
Start date Feb 26, 2015

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SSShaw

Guest

Feb 26, 2015

I am in a quandry.. and called CMS with no definitive answer.. I have a patient who received an OTS AFO.. 3 weeks later they are now prescribed a custom AFO .. They are both on the AFO LCD in Medicare.. Would this fall under the rules of Same & Similar (3 years) or does the "Off the Shelf" to "custom" supersede the rule (providing I have good notes)?
Thanks,
Sam

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