Showing codes L4050 (Replace molded calf lacer, for custom fabricated orthosis only) — L5150 (Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot)

L4050 - Replace molded calf lacer
Long description: Replace molded calf lacer, for custom fabricated orthosis only
Code added date: 19850101.
Code effective date: 20050101.
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).
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L4055 - Replace non-molded calf lace
Long description: Replace non-molded calf lacer, for custom fabricated orthosis only
Code added date: 19880101.
Code effective date: 20050101.
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).
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L4060 - Replace high roll cuff
Long description: Replace high roll cuff
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).
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L4070 - Replace prox & dist upright
Long description: Replace proximal and distal upright for kafo
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).
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L4080 - Repl met band kafo-afo prox
Long description: Replace metal bands kafo, proximal thigh
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).
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L4090 - Repl met band kafo-afo calf/
Long description: Replace metal bands kafo-afo, calf or distal thigh
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).
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L4100 - Repl leath cuff kafo prox th
Long description: Replace leather cuff kafo, proximal thigh
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).
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L4110 - Repl leath cuff kafo-afo cal
Long description: Replace leather cuff kafo-afo, calf or distal thigh
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).
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L4130 - Replace pretibial shell
Long description: Replace pretibial shell
Code added date: 19840101.
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).
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L4205 - Ortho dvc repair per 15 min
Long description: Repair of orthotic device, labor component, per 15 minutes
Code added date: 19970101.
Code effective date: 19970101.
Pricing Indicator Code(s): 46 ; (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).
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L4210 - Orth dev repair/repl minor p
Long description: Repair of orthotic device, repair or replace minor parts
Code added date: 19850101.
Code effective date: 19960101.
Pricing Indicator Code(s): 46 ; (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).
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L4350 - 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
Code added date: 19890101.
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).
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L4360 - Pneumat walking boot pre cst
Long description: Walking boot, pneumatic and/or vacuum, 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
Code added date: 19890101.
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).
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L4361 - 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
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).
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L4370 - Pneum full leg splnt pre ots
Long description: Pneumatic full leg splint, prefabricated, off-the-shelf
Code added date: 19890101.
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).
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L4386 - Non-pneum walk boot pre cst
Long description: 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
Code added date: 20030101.
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).
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L4387 - Non-pneum walk boot pre ots
Long description: Walking boot, non-pneumatic, with or without joints, with or without interface material, 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).
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L4392 - Replace afo soft interface
Long description: Replacement, soft interface material, static afo
Code added date: 19970101.
Code effective date: 20010101.
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).
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L4394 - Replace foot drop spint
Long description: Replace soft interface material, foot drop splint
Code added date: 19970101.
Code effective date: 19970101.
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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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