HCPCS Level II · Temporary codes for DME regional carriers
K0901Knee 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
Terminated 12/31/2016
Source: CMS HCPCS quarterly update, October 2026. Page updated September 29, 2026.
About K0901
K0901 is an HCPCS Level II code in the K series (temporary codes for DME regional carriers), describing 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.
It was added to HCPCS effective 10/01/2014, and its current record took effect 01/01/2017.
It was terminated on 12/31/2016 and can't be billed for later dates of service.
Its Medicare coverage code is "C", meaning coverage is left to the Medicare contractor's judgment.
Details
- Short description
- Ko single upright pre ots
- Date added
- 10/01/2014
- Action effective
- 01/01/2017
- Termination date
- 12/31/2016
- BETOS
- D1F
Related K09xx codes
Common questions about K0901
Is HCPCS K0901 still valid?
- No. K0901 was terminated on 12/31/2016.
Does Medicare cover K0901?
- Its coverage code is "C": coverage is left to the Medicare contractor's judgment. Check the local coverage determination for your region.