icd-10 code for l1902

L1902 - Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information.

Full Answer

What does l1902 stand for?

L1902 - Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf The above description is abbreviated. This code description may also have Includes, Excludes, Notes, Guidelines, Examples and other information. Access to this feature is available in the following products:

What does l1951 stand for?

L1951 (ANKLE FOOT ORTHOSIS, SPIRAL, (INSTITUTE OF REHABILITATIVE MEDICINE TYPE), plastic or other material, prefabricated, includes fitting and adjustment) describes a prefabricated Ankle Foot Orthosis designed to control dorsiflexion and plantarflexion motions of the ankle foot complex.

What does L 1920 stand for in Orthotics?

Included in the code are closure and clasp components. L1920 (ANKLE FOOT ORTHOSIS, SINGLE UPRIGHT WITH STATIC OR ADJUSTABLE STOP (PHELPS OR PERLSTEIN TYPE), CUSTOM FABRICATED) describes a custom fabricated Ankle Foot Orthosis designed to control only the plantarflexion motion of the ankle foot complex.

What is the ICD 10 code for R59?

R59.0 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2018/2019 edition of ICD-10-CM R59.0 became effective on October 1, 2018. This is the American ICD-10-CM version of R59.0 - other international versions of ICD-10 R59.0 may differ.

How do you bill for an ankle brace?

CPT codes L4396 and L4397 are used for an ankle-foot orthosis which is worn when a beneficiary is nonambulatory, or minimally ambulatory. CPT L4398 is used for an ankle-foot orthosis which is worn when a beneficiary is nonambulatory.

What is the CPT code for foot orthotics?

4) CPT code 97760, Orthotic management and training (including assessment and fitting when not otherwise reported) for custom-made orthotics, CPT code 97761, Prosthetic training, and CPT code 97762, Checkout for orthotic/prosthetic use, established patient.

What is CPT code L4397?

HCPCS code L4397 for Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf as maintained by CMS falls under Other Lower Extremity Orthotics .

What is CPT code l4350?

Short Description: ANKLE CONTROL ORTHO PRE OTS. Long Description: ANKLE CONTROL ORTHOSIS, STIRRUP STYLE, RIGID, INCLUDES ANY TYPE INTERFACE (E.G., PNEUMATIC, GEL), PREFABRICATED, OFF-THE-SHELF.

What is the ICD 10 code for orthotics?

Z46. 89 - Encounter for fitting and adjustment of other specified devices | ICD-10-CM.

What is the code for orthotics?

Orthotic Procedures and services HCPCS Code range L0112-L4631.

Does L1902 need a modifier?

Response: L1902 is covered if your medical necessity documentation conforms with that listed in the LCD. From a coding perspective, you must use the "KX" modifier (use of this stipulates you have the met documentation requirement in the LCD), and either an "RT" or "LT" modifier.

Does Medicare pay for L4397?

A static/dynamic ankle-foot orthosis (AFO) (L4396, L4397) and replacement interface (L4392) are denied as noncovered (no Medicare benefit) when they are used solely for the prevention or treatment of a heel pressure ulcer because for these indications they are not used to support a weak or deformed body member or to ...

What is CPT code L1970?

L1970: ANKLE FOOT ORTHOSIS, PLASTIC WITH ANKLE JOINT, CUSTOM-FABRICATED.

What is CPT code L3807?

HCPCS code L3807 for Wrist hand finger orthosis (WHFO), without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise as maintained by CMS falls under Wrist-hand-finger Orthotics .

What is CPT code L4386?

Long Description for L4386: WALKING BOOT, NON-PNEUMATIC, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED ITEM THAT HAS BEEN TRIMMED, BENT, MOLDED, ASSEMBLED, OR OTHERWISE CUSTOMIZED TO FIT A SPECIFIC PATIENT BY AN INDIVIDUAL WITH EXPERTISE.

What is HCPC code L4361?

Short Description: Pneuma/vac walk boot pre ots. Long Description: WALKING BOOT, PNEUMATIC AND/OR VACUUM, WITH OR WITHOUT JOINTS, WITH OR WITHOUT INTERFACE MATERIAL, PREFABRICATED, OFF-THE-SHELF.

How do you bill for foot orthotics?

The actual foot orthotic, if custom-made, would then be billed under the HCPCS code of L3030, which is a level-2 HCPCS code specific for a foot insert, removable, and formed to patient foot (custom-made). If it is a premolded, noncustom insert, the code would be L3060.

What is CPT code L3020?

Short Description: Foot longitud/metatarsal sup. Long Description: FOOT, INSERT, REMOVABLE, MOLDED TO PATIENT MODEL, LONGITUDINAL/ METATARSAL SUPPORT, EACH. Additional Search Terminology: Product and Service Code(s): OR01 : ORTHOSES: CUSTOM FABRICATED.

What is CPT code L3000?

HCPCS code L3000 is to be used for custom made orthotics (shoe inserts) and not for over the counter shoe inserts.

What does CPT code 97760 mean?

o CPT code 97760 (Orthotic(s) management and training (including assessment. and fitting when not otherwise reported), upper extremity(ies), lower. extremity(ies) and/or trunk, initial orthotic(s) encounter, each 15 minutes)

Policy

Aetna considers ankle orthoses, ankle-foot orthoses (AFOs), and knee-ankle-foot orthoses (KAFOs) medically necessary durable medical equipment (DME) according to the criteria set forth below. See background section of this clinical policy bulletin (CPB) for descriptions of the orthotics discussed in this policy.

Background

An orthosis (brace) is a rigid or semi-rigid device that is used for the purpose of supporting a weak or deformed body member or restricting or eliminating motion in a diseased or injured part of the body. An orthosis can be either pre-fabricated or custom-fabricated.

The above policy is based on the following references

Aboutorabi A, Arazpour M, Ahmadi Bani M, et al. Efficacy of ankle foot orthoses types on walking in children with cerebral palsy: A systematic review. Ann Phys Rehabil Med. 2017;60 (6):393-402.

General Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

Article Guidance

NON-MEDICAL NECESSITY COVERAGE AND PAYMENT RULES For any item to be covered by Medicare, it must 1) be eligible for a defined Medicare benefit category, 2) be reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member, and 3) meet all other applicable Medicare statutory and regulatory requirements.

ICD-10-CM Codes that Support Medical Necessity

The presence of an ICD-10 code listed in this section is not sufficient by itself to assure coverage. Refer to the LCD section on “ Coverage Indications, Limitations, and/or Medical Necessity ” for other coverage criteria and payment information.

ICD-10-CM Codes that DO NOT Support Medical Necessity

For the specific HCPCS codes indicated above, all ICD-10 codes that are not specified in the preceding section. For all other HCPCS codes, diagnoses are not specified.

Bill Type Codes

Contractors may specify Bill Types to help providers identify those Bill Types typically used to report this service. Absence of a Bill Type does not guarantee that the article does not apply to that Bill Type.

Revenue Codes

Contractors may specify Revenue Codes to help providers identify those Revenue Codes typically used to report this service. In most instances Revenue Codes are purely advisory. Unless specified in the article, services reported under other Revenue Codes are equally subject to this coverage determination.

LCD Information

CPT codes, descriptions and other data only are copyright 2020 American Medical Association. All Rights Reserved. Applicable FARS/HHSARS apply.

General Information

Section 1833 (e) of the Social Security Act precludes payment to any provider of services unless "there has been furnished such information as may be necessary in order to determine the amounts due such provider.” It is expected that the beneficiary's medical records will reflect the need for the care provided.