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05/26/2004    Pat Larabee, CPC, CCP

A5502 HCPCS Code

Query: A5502 HCPCS Code


Our podiatrist has been using A5502 (for
diabetics only, multiple density insert[s], per
shoe) when billing for diabetic shoe inserts.


I am in the process of revising his charge slip,
and, when I went to the
HCPCS manual, A5502 is no longer there. However,
when I go to the index and search for Inserts,
diabetic, it refers to A5502.


Was there an omission by error, or has this code
been deleted?


Pat Larabee, CPC, CCP
So. Portland, ME


Codingline Response: HCPCS code, A5502 (for
diabetics only, multiple density insert[s], per
shoe), was deleted in 2002. The A5509 and A5511
codes were developed to replace it.


As of April 1, 2004, DMERC introduced two new
temporary HCPSC codes, K0628 and K0629, to
replace A5509 and A5511.


K0628 is defined as “For diabetics only,
multiple density insert, direct-formed, molded
to foot after external heat source of 230
degrees Fahrenheit or higher, total contact with
patient's foot, including arch, base layer
minimum of ¼ inch material of shore a 35
durometer of 3/16 inch material of shore a 40
(or higher), prefabricated, each”.


K0629 is defined as “For diabetics only,
multiple density insert, custom-molded from
model of patient's foot, total contact with
patient's foot, including arch, base layer
minimum of 3/16 inch material of shore a 35
durometer or higher, includes arch filler and
other shaping material, custom fabricated,
each”.


The grace period for using A5509 and A5511 will
end June 30, 2004. Your doctor is 2 coding
generations behind…


Harry Goldsmith, DPM
Cerritos, CA


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