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
Short Description: Multi den insert custom mold
Coverage Code: Special coverage instructions apply
Action Code: No maintenance for this code
Date Added: January 1, 2006
Effective Date: January 1, 2019
Termination Date: