How to order a brace or orthosis with Scotts

How it works, step by step

1. Tell us what you need. Call (800) 304-7030, start in the order wizard, or have your clinician send a referral with the documents attached. If you already use a product, the manufacturer code on the box is the most useful thing you can give us: it settles size, style and fit without guesswork.
2. We verify your benefits first. Medicare Part B, Florida Medicaid, Medicare Advantage and most commercial plans. Before anything ships you hear what the plan covers and what your share is, and if it is not covered we say so and quote a private-pay option instead.
3. We collect the order and the documentation from your prescriber. For a brace or orthosis that usually means:
   • A written order specifying the brace type, the joint and the side (left or right — this is the single most common error on a brace order)
   • The diagnosis and, for post-operative bracing, the procedure and date
   • Range-of-motion settings if the brace is adjustable
   • Measurements — joint circumference, limb length, shoe size as applicable
   You do not chase the paperwork; we do, and we tell you if something is missing.
4. Delivery or shipping. Delivered and set up across South Florida, or shipped across Florida, with the instructions you need and a phone number for the questions that come later.
5. Resupply, if it applies. Supplies that recur are tracked on the policy’s schedule. We check in before each shipment; nothing ships that you did not ask for. How automatic resupply works.

What Medicare looks for

Ankle-foot orthosis (foot drop) is covered under Medicare policy LCD L33686, Ankle-Foot/Knee-Ankle-Foot Orthosis. In plain words, the chart has to show this: Covered for a patient who is AMBULATORY and has weakness or deformity of the foot and ankle needing stabilisation for medical reasons, with a reasonable expectation of improved function. A non-ambulatory patient does NOT qualify for an ambulatory AFO — that is the most common denial here. The diagnoses it names include foot drop, lesion of lateral popliteal nerve, sequelae of cerebral infarction, hemiplegia, multiple sclerosis. Resupply under the policy is one-time purchase.

Knee orthosis is covered under Medicare policy LCD L33318, Knee Orthoses. In plain words, the chart has to show this: Diagnosis match only — not automatic qualification. A rigid or semi-rigid knee orthosis needs documentation of knee instability or a need to restrict motion after injury or surgery. the ordered brace must match that purpose. Custom-fabricated needs a documented reason a prefabricated brace will not work. Add KX only after all coverage criteria are met. check the exact code and date of service. The diagnoses it names include pain in right knee, pain in left knee, derangement of medial meniscus from old tear/injury, unspecified knee, chronic instability of knee, unspecified knee, bucket-handle tear of medial meniscus, current injury, unspecified knee, initial encounter. Resupply under the policy is one-time purchase.

Ankle brace / ankle-foot orthosis is covered under Medicare policy LCD L33686, Ankle-Foot/Knee-Ankle-Foot Orthosis. In plain words, the chart has to show this: Diagnosis match only — not automatic qualification. Medicare covers the listed ambulatory AFO codes only when the beneficiary is ambulatory, has foot/ankle weakness or deformity, needs stabilization for a medical reason, and can benefit functionally. verify the actual plan. The diagnoses it names include sprain of unspecified ligament of ankle, primary osteoarthritis of ankle and foot. Resupply under the policy is one-time purchase.

Wrist / hand orthosis is covered under Medicare policy LCD brace benefit, Medicare braces benefit and current DMEPOS coding/PA rules. In plain words, the chart has to show this: Diagnosis match only — not automatic qualification. The record must connect the wrist/hand condition to a rigid or semi-rigid device that supports a weak/deformed body member or restricts motion in a diseased/injured part. A broad osteoarthritis family is suppressed unless wrist/hand anatomy is in the code or extracted description. Add KX only after all coverage criteria are met. check exact code and date. The diagnoses it names include carpal tunnel syndrome, unspecified upper limb, carpal tunnel syndrome, right upper limb, carpal tunnel syndrome, left upper limb, carpal tunnel syndrome, bilateral upper limbs, osteoarthritis of first carpometacarpal joint. Resupply under the policy is one-time purchase.

Elbow orthosis is covered under Medicare policy LCD brace benefit, Medicare braces benefit and current DMEPOS coding/PA rules. In plain words, the chart has to show this: Diagnosis match only — not automatic qualification. The chart must tie the elbow condition and functional need to the exact rigid/semi-rigid orthosis. a soft counterforce strap is not automatically the same product or benefit. The diagnoses it names include lateral epicondylitis (tennis elbow), primary osteoarthritis of elbow, osteoarthritis with elbow anatomy documented. Resupply under the policy is one-time purchase.

Spinal orthosis (TLSO / LSO) is covered under Medicare policy LCD L33790, Spinal Orthoses: TLSO and LSO. In plain words, the chart has to show this: Diagnosis match only — not automatic qualification. Coverage requires the orthosis to reduce pain by restricting trunk mobility, facilitate healing after injury/surgery, or support weak spinal muscles. low-back pain alone is not enough. Custom-fabricated needs a documented reason prefabricated will not serve. verify exact code and DOS. managed plans may differ. The diagnoses it names include spinal stenosis, sacral and sacrococcygeal region, other intervertebral disc displacement, lumbar region, spondylosis without myelopathy or radiculopathy, lumbosacral region, infantile idiopathic scoliosis, sacral/sacrococcygeal region, lumbago with sciatica. Resupply under the policy is one-time purchase.

Policies change and plans differ; the link above is the current text. We do not publish allowances or quantity limits here because the number that applies to you depends on your plan and your chart. Ask us and we will tell you yours.

Products people order

The manufacturers’ own photographs, shown under our dealer agreements. Pick one to check coverage and order it; sizes and pack counts come next.

Sammons PrestonOval-8 Finger Splints, size 55 sizes or packs · HCPCS L1820Duro-Med Industries®Heelbo® Heel and Elbow Protectors, Large4 sizes or packs · HCPCS L1820FLA OrthopedicsActimove Episport Elbow Support, black, medium3 sizes or packs · HCPCS L1820Thermoskin Carpal Tunnel Glove, Small Left, Black3 sizes or packs · HCPCS A6530FLA OrthopedicsWomen's Pro-Lite Deluxe Maternity Support Belt, medium3 sizes or packsCore Products International, Inc.Elasti Sacroiliac Support with Pad, 3XL2 sizes or packs · HCPCS A6530

All bracing & orthopedics product families

Brands we carry

FLA Orthopedics, Performance Health, Sammons Preston, Drive Medical, Medline.

Questions people ask

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