Retired - Ankle-Foot Orthoses – Arizona-Type – Correct Coding
Arizona AFO is a company that manufactures a line of custom fabricated ankle-foot orthoses. Other companies manufacture similar products. The Pricing, Data Analysis, and Coding (PDAC) contractor has recently reviewed the Arizona AFO line of products and determined the appropriate HCPCS codes to be used when billing for these and similar items.
For the Arizona Short, Arizona Tall, Arizona Extended, Arizona Unweighting, and similar custom fabricated braces, only the following codes should be used:
|L1940||Ankle foot orthosis, plastic or other material, custom fabricated|
|L2330||Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only|
|L2820||Addition to lower extremity orthosis, soft interface for molded plastic below knee section|
L2330 is used whether the closure is a lacer closure or a velcro closure. L2820 is used only if a soft interface, either leather or other material, is provided.
The following codes must not be used for these braces:
|L1960||Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated|
|L2275||Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined|
|L2280||Addition to lower extremity, molded inner boot|
For the Arizona Partial Foot model or similar orthosis, use codes L1940, L2330, L2820, and L5000 (Partial foot, shoe insert with longitudinal arch, toe filler).
Questions concerning the coding of other orthoses should be referred to the PDAC contractor.
Suppliers who have incorrectly coded these orthoses should submit a voluntary refund to the DME MAC.
|12/04/2008||Published on PDAC website|