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

IMPORTANT: THIS DOCUMENT CONTAINS OUTDATED INFORMATION.Content Provided on this page contains outdated information and instruction and should not be considered current. Noridian is providing this archived information for research purposes only. This archived article contains previously issued instructions that have since been updated or are no longer applicable for Medicare billing purposes.

Original Effective Date: 12/04/2008
Revision Effective Date: 11/01/2013

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 recently reviewed the Arizona AFO line of products and determined the appropriate HCPCS codes to be used when billing for these and similar items.

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

HCPCS Code 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 velcro closure. L2820 is used only if a soft interface, either leather or other material, is provided.

The following codes must not be used for these braces:

HCPCS Code Description
L1960 Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
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 L1940, L2330, L2820, and L5000 (Partial foot, shoe insert with longitudinal arch, toe filler). Questions concerning the coding of other orthoses should be referred to the Pricing, Data Analysis, and Coding (PDAC) contractor. Suppliers who have incorrectly coded these orthoses should submit a voluntary refund to the DME MAC.

Publication History

Date of Change Description
12/04/08 Originally Published
11/01/13 Revised
10/22/20 Revised. See current article published on 10/22/20

 

            Last Updated Wed, 21 Oct 2020 19:41:39 +0000