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MA05.010n, Ankle-Foot/Knee-Ankle-Foot Orthosis
Effective date
Oct 28, 2026
Identified
Oct 20, 2026
Summary
Independence Blue Cross Medicare Advantage policy MA05.010n adds Face-to-Face requirements per CMS Final Rule for three ankle-foot orthosis HCPCS codes (L1906, L1933, L1952), effective 2026-10-28. Billing teams must verify that prescribing providers have completed face-to-face encounters with patients before submitting claims for these specific orthotic codes.
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What to do
Action · 5 steps
01By 2026-10-28: Billing team must implement Face-to-Face encounter verification for HCPCS codes L1906, L1933, and L1952 on all Independence Blue Cross Medicare Advantage claims.
02Before submitting claims for these three codes, verify that the prescribing provider has documented a face-to-face encounter with the patient in accordance with the CMS Final Rule.
03Update claim submission workflows, prior authorization processes, and claim scrubbing logic to flag and reject claims for L1906, L1933, and L1952 that lack evidence of a completed face-to-face encounter.
04Communicate this requirement to providers and intake staff to ensure encounter documentation is collected and retained at point of service.
05Claims submitted without documented face-to-face encounters for these codes will be denied by Independence Blue Cross Medicare Advantage.
Codes mentioned
L1906L1933L1952
Original notice
MA05.010n, Ankle-Foot/Knee-Ankle-Foot Orthosis
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
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