OTS Orthotics-Minimal Self Adjustment

In today’s orthotic world we are getting blasted with the term “OTS-Minimal Self Adjustment.” By now most of us are up to speed on its definition and scope, but just for a refresher, here you go: CMS regulations 42 CFR 414.402 define Minimal Self-Adjustment (MSA) to mean an adjustment that the beneficiary, caretaker for the beneficiary, or a supplier of the device can perform and that does not require the services of a certified Orthotist (that is, an individual who is certified by the American Board for Certification in Orthotics and Prosthetics, Inc., or by the Board for Orthotist/Prosthetist Certification) or an individual who has specialized training.

OTS codes that fall under these guidelines include, but are not limited to L0120 through L4398 and K-Codes-K0901 and K0902. Please refer to the Medicare Fee for Service website at www.cms.gov for a complete list. It is important to note that in some cases there are two codes in the HCPCS that may both describe a particular prefabricated orthotic product. One code is allocated to the device that is designated as Off-the-Shelf (OTS) and a second for when the device is furnished for custom fitting. In these cases, the code that describes a custom fitted orthotic cannot be used unless the custom fitting has been performed and the supplier is in compliance with Appendix C of the DMEPOS quality standards. This is also the case for any code for a prefabricated orthotic that requires more than minimal self-adjustment and requires expertise in fitting or customizing.

brad blog About the Author

Brad Mattear L.O., CPA is the Midwest Territory Manager and National Key Accounts Manager for Cascade Orthopedic Supply. He is a licensed Orthotist (L.O.) and a Certified Prosthetic Assistant (CPA). Brad has been in the O&P field for over 15 years and is involved with many well-respected groups within the industry including the following: 

OPTA: Orthotic Prosthetic Technological Association- Vice President
US-ISPO: International Society Prosthetics Orthotics- Board Member
ABC Central Fabrication Accreditation Committee- Chairman
ABC Technician Exam Committee-Member
AOPA-American Orthotic Prosthetic Association-Chairman Technician Program

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