Summary & Overview
HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated
HCPCS Level II code K0902 denotes a prefabricated, off‑the‑shelf double‑upright knee orthosis with adjustable flexion/extension joint and medial‑lateral/rotation control, optionally with varus/valgus adjustment. This orthotic device is commonly used to stabilize the knee after ligament injuries, during rehabilitation, and for alignment control in degenerative or deformity conditions. Nationally, the code matters because it defines coverage and billing for a widely used class of durable medical equipment that impacts post‑operative care and conservative management of knee instability.
Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of what the code represents, the clinical contexts in which the device is used, and the typical sites of service. The full publication provides benchmarks for utilization and reimbursement, recent policy updates affecting orthotic coverage, billing considerations for prefabricated versus custom devices, and clinical implications for device selection. Data limitations: modifiers, associated taxonomies, specific ICD‑10 diagnosis linkages, related codes, and payer‑specific coverage details are not available in the input and are noted where applicable in the full report.
Billing Code Overview
HCPCS Level II code K0902 describes a knee orthosis (KO), double 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. This device is designed to provide rigid support and controlled joint motion for patients with knee instability, ligament injuries, postoperative stabilization needs, or deformity requiring varus/valgus control.
Service type: Durable Medical Equipment / Orthotic Device
Typical site of service: Outpatient clinics, orthotic/prosthetic supply facilities, ambulatory surgery centers for post‑operative fitting, and home use following dispensing
Data not available in the input for modifiers, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult with symptomatic knee instability or post-operative protection following ligament repair who presents to an orthotics clinic after referral from an orthopedic surgeon or physical therapist. The patient may have diagnoses such as a medial collateral ligament sprain, posterolateral corner injury, or proximal tibial fracture requiring a stabilized knee joint. The clinical workflow begins with an initial evaluation by an orthotist or orthopedic clinician to assess joint range of motion, laxity, swelling, and skin integrity. Measurements are taken for an off-the-shelf double upright knee orthosis with adjustable flexion/extension joints (K0902). The orthosis is sized and fitted in clinic; gait and functional checks are performed, and joint stops are set to prescribed flexion/extension limits. Patient education on donning/doffing, skin checks, and activity restrictions is provided. Follow-up visits occur to confirm fit, adjust joint settings (for example to gradually increase allowed flexion), and document functional progress. If the device cannot be fitted or requires customization, the orthotist documents reasons and communicates with the referring provider for next steps.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | When the orthosis is supplied for the right lower extremity |