Showing codes L4360 (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) — L5331 (Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot)

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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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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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).
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