Medicare & Insurance

MEDICARE and INSURANCE, L-codes

In most cases, the Arizona AFO is covered by Medicare reimbursement when prescribed by a physician for approved applications.  However it is the patient’s responsibility to verify coverage and secure any necessary pre-approvals.

Health Insurance Reimbursement

The Arizona AFO is usually covered for approved applications by most health insurance plans. However it is the patient’s responsibility to verify coverage and secure any necessary pre-approvals.  Always consult your health plan.

VARIOUS L-CODES AND DESCRIPTORS THAT MAY BE USED IN BILLING MEDICARE

L-1940 A semi-rigid molded plastic orthosis to hold the foot in neutral position (dorsi -plantar flexion), controls foot position, custom molded from a model of the patient, custom fabricated, includes casting and cast preparation.

L-1960 A rigid orthosis to control the foot and ankle, custom molded from a model of the patient, custom fabricated, includes casting and cast preparation.

L-2330 A leather, or similar material, lacer molded from a model of the patient, that fits around the calf area, includes casting and cast preparation.

L-2820 Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section.

Medicare Assigned L-Codes by Product Styles

Standard-Short (L-1940, L-2330, L-2820, - For a total of three codes)

Standard-Tall (L-1940, L-2330, L-2820, - For a total of three codes)

Extended (L-1960, L-2330, L-2820 For a total of three codes)

Unweighting (L-1960, L-2330, L-2820 For a total of three codes)

Partial Foot (L-1940, L-2330, L-2820, L-5000 For a total of four codes)

The final and sole responsibility for the correct coding, within established laws, rules, and standards of practice, rests upon the party submitting the claim.

 

MEDICARE COMPLIANCE DOCUMENTATION