icd 10 codes used for l1902 code

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 is the ICD 10 code for X2?

J09.X2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM J09.X2 became effective on October 1, 2021. This is the American ICD-10-CM version of J09.X2 - other international versions of ICD-10 J09.X2 may differ.

What are the CPT codes l4396 and l4397?

Codes L4396, L4397 and L4392 will be denied as not reasonable and necessary for a beneficiary with a foot drop but without an ankle flexion contracture.

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.

What is CPT code L1902?

L1902 (ANKLE ORTHOSIS, ANKLE GAUNTLET OR SIMILAR, WITH OR WITHOUT JOINTS, PREFABRICATED, OFF-THE-SHELF) describes a prefabricated ankle orthosis (AO) designed to provide compression and resist motion of the ankle foot complex.

Does Medicare pay for off the shelf orthotics?

Orthotic devices are primarily covered under Medicare Part B. As with all Medicare Part B services, covered orthotics must be reasonable and necessary for the diagnosis or treatment of an illness or injury.

Does Medicare pay for AFO braces?

Ankle-foot orthoses (AFO) and knee-ankle foot orthoses (KAFO) are covered under the Medicare Braces Benefit.

Does Medicare Cover Richie brace?

Replacement of ankle joints, plastic limb supports, top covers and Arch Suspenders must be done by an authorized Richie Brace lab distributor. These repairs should be billed to Medicare and will qualify for reimbursement up the full value of the original brace.

What is Lumbar Sacral Orthosis sagittal coronal control?

Long Description: LUMBAR-SACRAL ORTHOSIS, SAGITTAL-CORONAL CONTROL, WITH RIGID ANTERIOR AND POSTERIOR FRAME/PANELS, POSTERIOR EXTENDS FROM SACROCOCCYGEAL JUNCTION TO T-9 VERTEBRA, LATERAL STRENGTH PROVIDED BY RIGID LATERAL FRAME/PANELS, PRODUCES INTRACAVITARY PRESSURE TO REDUCE LOAD ON INTERVERTEBRAL DISCS, INCLUDES ...

How do you bill for orthotics?

There is no specific CPT code for casting for orthotic devices. It is recommended to use the unlisted casting code 29799 for this purpose. Bill this code once.

What are the CPT codes for 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.

Does Medicare Part B Cover foot orthotics?

Medicare Part B pays for 80 percent of the approved cost of either custom-made or pre-made orthotic devices. Of course, this is only possible if your health care provider feels it is medically necessary. Medicare categorizes orthotics under the durable medical equipment (DME) benefit.

What is an AFO ankle brace?

An ankle foot orthosis (AFO) is used to improve walking patterns by reducing, preventing or limiting movement of the lower leg and foot and by supporting weak muscles. They are also used to maintain joint alignment, accommodate deformity and to help reduce spasticity.

What is AFO DME?

Ankle-foot orthoses (AFO) are considered medically necessary DME for ambulatory members with weakness or deformity of the foot and ankle, which require stabilization for medical reasons, and have the potential to benefit functionally.

Can you claim orthotics on Medicare?

Orthotic services are not included in the Medicare Benefits Schedule and this significantly restricts access to these essential services for persons with chronic disease. This results in substantial problems for those with diabetes, arthritis and stroke survivors.

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.

What is J10.01?

J10.01 Influenza due to other identified influenza virus with the same other identified influenza virus pneumonia. J10.08 Influenza due to other identified influenza virus with other specified pneumonia. J10.1 Influenza due to other identified influenza virus with other respiratory manifestations.

What does the title of a manifestation code mean?

In most cases the manifestation codes will have in the code title, "in diseases classified elsewhere.". Codes with this title are a component of the etiology/manifestation convention. The code title indicates that it is a manifestation code.