Query: L3020 Orthotic Code
Our office has been using different orthotics, and the doctor would like to know more information about the L3020 type, code. Can the casting code, CPT 29799, and material code A4580 be used with L3020? Are they payable with this code? Where can I find a listing or DME book or website that we can find this kind of information.
VIcki Hicks, Office of Daniel Brown, DPM, Herrin, IL
Response: L3000-L3060 are the appropriate codes for foot orthotics, each described in HCPSC.
L3000-L3060 foot orthotics are statuatorily non-covered under Medicare. To provide you with a universal policy for non-Medicare commercial carriers would be impossible because some non-Medicare payers don't reimburse foot orthotics, others may include the casting within the orthotic allowance, while others do not.
The nuances of the various different types of foot orthotics these codes describe may be found with excellent illustrations in "The Illustrated Guide to Orthotics and Prosthetics" published by the American Orthotic and Prosthetic Association (AOPA- http://www.aopanet.org/). You may also want to review previous articles in Podiatry Management (I did a series on DME's for podiatrists) or search the Codingline Forum either for "orthotics" or the specific L3000 through L3060 type (be sure to select "all dates" and "message bodies").
Paul Kesselman, DPM, Woodside, NY
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