HCPCS Code Section: HCPCS L Codes

Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated Short Description: Afo molded ankle gauntlet Coverage Code: Carrier judgment Action Code: No maintenance for this code …

Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf Short Description: Afo ankle gauntlet pre ots Coverage Code: Carrier judgment Action Code: No maintenance for this …

Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated Short Description: Afo sprng wir drsflx calf bd Coverage Code: Carrier judgment Action Code: No maintenance for this …

Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment Short Description: Afo w/ankle joint, prefab Coverage Code: Carrier judgment Action Code: No maintenance …

Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk) Short Description: Ko supracondylar socket mold Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Ankle foot orthosis, plastic with ankle joint, custom fabricated Short Description: Afo plastic molded w/ankle j Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf Short …

Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated Short Description: Afo pos solid ank plastic mo Coverage Code: Carrier judgment Action Code: No maintenance for this code Date …

Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf Short …

Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment Short Description: Afo spiral prefabricated Coverage Code: Carrier judgment Action Code: …