Showing codes L4396 (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) — L5460 (Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee)

L4396 - Static or dynami afo pre cst
Long description: 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
Code added date: 19970101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L4397 - Static or dynami afo pre ots
Long description: 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
Code added date: 20140101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L4398 - Foot drop splint pre ots
Long description: Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf
Code added date: 19970101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L4631 - Afo, walk boot type, cus fab
Long description: Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated
Code added date: 20110101.
Code effective date: 20110101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5000 - Sho insert w arch toe filler
Long description: Partial foot, shoe insert with longitudinal arch, toe filler
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
HTML    PDF

L5010 - Mold socket ank hgt w/ toe f
Long description: Partial foot, molded socket, ankle height, with toe filler
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
HTML    PDF

L5020 - Tibial tubercle hgt w/ toe f
Long description: Partial foot, molded socket, tibial tubercle height, with toe filler
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: D (A code denoting Medicare coverage status).
HTML    PDF

L5050 - Ank symes mold sckt sach ft
Long description: Ankle, symes, molded socket, sach foot
Code added date: 19850101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5060 - Symes met fr leath socket ar
Long description: Ankle, symes, metal frame, molded leather socket, articulated ankle/foot
Code added date: 19850101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5100 - Molded socket shin sach foot
Long description: Below knee, molded socket, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5105 - Plast socket jts/thgh lacer
Long description: Below knee, plastic socket, joints and thigh lacer, sach foot
Code added date: 19890101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5150 - Mold sckt ext knee shin sach
Long description: Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5160 - Mold socket bent knee shin s
Long description: Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5200 - Kne sing axis fric shin sach
Long description: Above knee, molded socket, single axis constant friction knee, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5210 - No knee/ankle joints w/ ft b
Long description: Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5220 - No knee joint with artic ali
Long description: Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5230 - Fem focal defic constant fri
Long description: Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5250 - Hip canad sing axi cons fric
Long description: Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5270 - Tilt table locking hip sing
Long description: Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5280 - Hemipelvect canad sing axis
Long description: Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5301 - Bk mold socket sach ft endo
Long description: Below knee, molded socket, shin, sach foot, endoskeletal system
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5312 - Knee disart, sach ft, endo
Long description: Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system
Code added date: 20120101.
Code effective date: 20120101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5321 - Ak open end sach
Long description: Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5331 - Hip disart canadian sach ft
Long description: Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5341 - Hemipelvectomy canadian sach
Long description: Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5400 - Postop dress & 1 cast chg bk
Long description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5410 - Postop dsg bk ea add cast ch
Long description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5420 - Postop dsg & 1 cast chg ak/d
Long description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5430 - Postop dsg ak ea add cast ch
Long description: Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5450 - Postop app non-wgt bear dsg
Long description: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF

L5460 - Postop app non-wgt bear dsg
Long description: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee
Code added date: 19820101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
HTML    PDF