What is CPT code L4396?
What is CPT code L4396?
HCPCS code L4396 for Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise as …
Does Medicare pay L4396?
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. Medicare does not reimburse for a foot drop splint/recumbent positioning device (L4398) or replacement interface (L4394).
Does Medicare cover L1812?
A knee orthosis with joints (L1810, L1812) or knee orthosis with condylar pads and joints with or without patellar control (L1820) are covered for ambulatory beneficiaries who have weakness or deformity of the knee and require stabilization.
Does Medicare cover L4386?
HCPCS codes L4360, L4361, L4386 and L4387 describe an ankle-foot orthosis commonly referred to as a walking boot. Medicare covers therapeutic shoes, as described in the Therapeutic Shoes for Persons with Diabetes local coverage determination (LCD), for the prevention and treatment of diabetic foot ulcers.
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.
What is CPT l1812?
Short Description: Ko elastic w/joints pre ots. Long Description: KNEE ORTHOSIS, ELASTIC WITH JOINTS, PREFABRICATED, OFF-THE-SHELF.
Is a cast considered durable medical equipment?
Comfort, non-therapeutic cast-braces are considered medically necessary DME after a fracture or surgery.
Is an AFO covered by Medicare?
Ankle-foot orthoses (AFO) and knee-ankle foot orthoses (KAFO) are covered under the Medicare Braces Benefit. Items that do not meet the definition of a brace are statutorily non covered, no benefit. Both “off-the-shelf” (OTS) and custom-fit items are considered prefabricated braces for Medicare coding purposes.
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