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HCPCS Code Information


Any billing code information provided by DeRoyal Industries, Inc. (“DeRoyal”) is only a recommendation provided for the convenience of and as a resource to healthcare professionals. These recommendations are based upon private and public information including billing descriptors, diagnostic codes, Medicare PDAC information and information from experienced consultants and DMEPOS suppliers. DeRoyal does not guarantee or imply claim reimbursement or coverage for any specific DeRoyal product or in any specific amount. The Durable Medical Equipment (DME) Medicare Administrative Contractor (MAC) for your region ultimately determines the appropriateness of reimbursement of a particular product, for a particular patient, given the appropriate diagnosis. DeRoyal strongly cautions the users of this information to always verify the applicability of a given billing code with their MAC prior to seeking reimbursement for a DeRoyal product. For more information, please visit the following websites:

DeRoyal orthopedic products are primarily reimbursable as “off-the-shelf” orthotics and should be coded accordingly. However, in certain circumstances, some DeRoyal orthopedic products may be modified significantly by the supplier or healthcare professional in order to specifically tailor the fit or function of the orthosis to a particular patient. In some of these cases, the orthosis may be reimbursable as “custom fitted.” DeRoyal strongly cautions suppliers or healthcare professionals to ensure that any items submitted as “custom-fitted” meet all the criteria applicable to the appropriate utilization of that designation and related codes.

This information does not constitute medical advice. Information provided by DeRoyal to customers and potential customers related to treatment protocols, product suggestions or billing code recommendations is provided for the convenience of healthcare professionals who, in their professional judgement, utilize DeRoyal products in the treatment of their patients. DeRoyal makes every attempt to ensure the accuracy and completeness of this information; however, diagnosis and treatment must be tailored to the specific circumstances of each patient. No information provided by DeRoyal should be used as a substitute for the professional judgment of a licensed healthcare professional.

The billing information provided by DeRoyal is subject to change by the appropriate Medicare authorities and, while DeRoyal makes every reasonable attempt to update this information regularly, the applicability of any information provided should be verified with the appropriate Medicare authority prior to the submission of any claim for reimbursement. Any questions concerning reimbursement should be directed to the appropriate MAC authority.             

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