HCPCS Code Section: HCPCS L Codes

Surgical boot, each, infant Short Description: Surgical boot each infant Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1984 Effective …

Orthopedic shoe, hightop with supinator or pronator, junior Short Description: Hightop w/ supp/pronator jun Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Orthopedic shoe, hightop with supinator or pronator, child Short Description: Hightop w/ supp/pronator chi Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Orthopedic shoe, hightop with supinator or pronator, infant Short Description: Hightop w/ supp/pronator inf Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: …

Orthopedic footwear, woman’s shoe, oxford, used as an integral part of a brace (orthosis) Short Description: Woman’s shoe oxford brace Coverage Code: Special coverage instructions apply Action Code: No …

Lift, elevation, metal extension (skate) Short Description: Lifts elevation metal extens Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1986 …

Orthopedic footwear, mens shoe, hightop, depth inlay, each Short Description: Mens shoes hightop depth inl Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date …

Lift, elevation, heel and sole, cork, per inch Short Description: Shoe lift elev heel/sole cor Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Orthopedic footwear, mens shoe, depth inlay, each Short Description: Orthopedic mens shoes dpth i Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: …

Lift, elevation, heel and sole, neoprene, per inch Short Description: Shoe lift elev heel/sole neo Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …