HCPCS Code Section: HCPCS L Codes

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 …

Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated Short Description: Hkafo torsion bil rot straps Coverage Code: Carrier judgment Action Code: No maintenance …

Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated Short Description: Kafo w/o joint multi-axis an Coverage Code: Carrier judgment Action Code: …

Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated Short Description: Kafo plas sing free knee …

Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated Short Description: Kafo plas doub free knee …

Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment Short Description: Kafo plastic pediatric size Coverage Code: Carrier judgment Action …

Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated Short Description: Kafo …