<< --CODE WHAT YOU PROVIDE & PROVIDE WHAT YOU CODE-- >>
practical and fair advice to today ' s practitioners dispensing devices under the Therapeutic Shoes For Diabetics Medical Policy . Effective October 1 , 2015 to replace multi-density inserts , documentation is needed by supplier substantiating the need for replacement . The supplier does not need a new prescription if done within the same calendar year . Modification of a custom molded diabetic shoe or diabetic depth shoe may be covered as a substitute for an insert . The following are the most common shoe modifications , rigid rocker bottoms , roller bottoms , wedges , metatarsal bars , or offset heels . Other modifications to diabetic shoes include but are not limited to flared heels . If foot is missing hallux , toes to determine if all AFO HCPCS codes are relative to one ' s scope of practice . The LCD for AFO ' s specifically prohibits for the use of some devices solely for the treatment of ulcers but does provide some coverage for certain orthopedic deformities . If one is utilizing AFO device for pressure offloading one must use the HCPCS code A9283 . The HCPCS codes L4396 and L4397 are covered if the patient has a plantar flexion contracture of the ankle , has a reasonable expectation of the ability to correct the contracture , and the contracture is interfering , or expected to interfere significantly with the beneficiary ' s functional abilities , used as a component of a therapy program which includes active
<< --JUST BECAUSE THERE IS A HCPCS CODE ASSIGNED TO THE SPECIFIC DEVIC- ES OR MODIFICATIONS BEING PROVIDED IT DOES NOT NECESSARILY MEAN THAT THERE IS REIMBURSEMENT FOR SUCH ITEMS OR SERVICES BY MEDICARE OR THIRD PARTY PAYERS . -- >>
Photo : @ iStock . com / live2create or forefoot , arch support with filler understood to require additional rigidity than foot insert without filler should be billed as an L5000 . Medicare does have provision for billing a code when the practitioner has done the work as ordered by a beneficiary but the beneficiary dies before the items can be picked up .
Utilizing the AFO HCPCS coding section of the document , HCPCS codes L1900 through L2999 , L4002 through L4398 and L4631 this type of device can be submitted for reimbursement . Refer to one ' s credentialing body or licensing body stretching of the involve the muscles or tendons or if the beneficiary has plantar fasciitis . Medicare does not reimburse for a foot drop splint / recumbent positioning device HCPCS ' s code L4398 or L4394 . AFO ' s used during ambulation are assigned HCPCS ' s codes L1900 , L1902 through L1990 , L2106 through L2116 , L4350 , L4360 , L4361 , L4386 , L4387 and L4631 . These are covered for ambulatory beneficiaries whose weakness or deformity of the foot and ankle requires stabilization for medical reasons and have the potential to benefit functionally . The PCC has developed the follow-
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