Additive Manufacturing Is Now Approved For Prosthetic Coding And Reimbursement

The Prosthetics and Orthotics Podcast

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Two sentences from PDAC can potentially change the course of manufacturing history for O & P: additive manufacturing is now explicitly acceptable for coding prosthetic devices that meet existing HCPCS descriptions. We unpack what that clarity means for clinicians, patients, vendors, and payers, and how to adopt 3D printing.

• Why PDAC’s language ends the gray area for 3D‑printed prosthetics
• What PDAC and DME MAC do and how they shape coding
• How to match additive devices to existing L code descriptions
• Documentation discipline to avoid denials and audits
• FDA’s proactive stance and signals to industry
• Medicare vs Medicare Advantage realities for reimbursement
• When new codes help vs when they stall at zero pay
• Scaling care amid workforce shortages using digital workflows
• Using additive to improve fit, speed, and repeatability
• Practical steps to start: scanning, CAD, materials, records
Special thanks to Advanced 3D for sponsoring this episode.

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1. Welcome And Host Catch-Up (00:00:00)

2. The Big PDAC Announcement (00:02:12)

3. What PDAC And DME MAC Actually Do (00:04:55)

4. From Gray Area To Clear Approval (00:08:20)

5. FDA’s Stance And Market Signals (00:11:20)

6. Coding Basics And Real-World Examples (00:13:18)

7. Compliance, Fraud Risks, And Best Practice (00:17:10)

8. Insurers, Medicare Advantage, And Reimbursement (00:20:00)

9. Industry Maturity And Workforce Pressures (00:23:05)

10. No New 3D Code: Why That Matters (00:25:00)

11. Utilization, New Codes, And Zero Pay Risk (00:28:00)

12. Tipping Point For Big Manufacturers (00:30:35)