Ankle-Foot Orthoses - Arizona-Type - Correct Coding - REVISED

Joint DME MAC Article
Posted 10/22/20

Arizona AFO is a company that manufactures a line of custom fabricated ankle-foot orthoses. Other companies manufacture similar products. The Pricing, Data Analysis, and Coding (PDAC) contractor has listed the Arizona AFO line of products on the Product Classification List (PCL)

For the Arizona Short and Arizona Tall, or similar custom fabricated braces, only the following codes should be used:

HCPCS Description
L1940 Ankle foot orthosis, plastic or other material, custom fabricated
L2330 Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820 Addition to lower extremity orthosis, soft interface for molded plastic below knee section

 

L2330 is used whether the closure is a lacer closure or a hook and loop closure. L2820 is used only if a soft interface, either leather or other material, is provided.

For the Arizona Extended and the Arizona Unweighting or similar custom fabricated braces, only the following codes should be used:

HCPCS Description
L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom-fabricated
L2330 Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820 Addition to lower extremity orthosis, soft interface for molded plastic below knee section

 

The following codes must not be used for these orthoses:

HCPCS Description
L2275 Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
L2280 Addition to lower extremity, molded inner boot

 

For the Arizona Partial Foot model or similar orthosis, use codes:

HCPCS Description
L1940 Ankle foot orthosis, plastic or other material, custom-fabricated
L2330 Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820 Addition to lower extremity orthosis, soft interface for molded plastic below knee section
L5000 Partial foot, shoe insert with longitudinal arch, toe filler.

 

Suppliers, manufacturers and distributors are reminded to check the product listing on the Product Classification List located on Durable Medical Equipment Coding System (DMECS); if there are any changes they are to notify the PDAC.

Suppliers who have incorrectly coded these orthoses should submit a voluntary refund to the DME MAC.

For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 5:00 p.m. ET, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form located on the PDAC website: https://www.dmepdac.com.

Publication History

Date of Change Description
12/04/08 Originally Published
11/01/13 Revised - Section related to Arizona Extended and the Arizona Unweighting or similar custom fabricated braces
10/22/20 Reviewed and Revised to make current

 

Last Updated Wed, 14 Jul 2021 15:15:51 +0000