HCPCS Code Section: HCPCS L Codes

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 …

Orthopedic footwear, mens shoe, oxford, each Short Description: Orthopedic mens shoes oxford Coverage Code: Non-covered by Medicare statute Action Code: No maintenance for this code Date Added: January 1, …

Lift, elevation, heel, tapered to metatarsals, per inch Short Description: Sho lift taper to metatarsal Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

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

Plastazote sandal, each Short Description: Plastazote sandal each Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1984 Effective Date: January 1, 1996 …

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

Orthopedic footwear, additional charge for split size Short Description: Orth foot add charge split s Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …

Non-standard size or length Short Description: Orth foot non-standard size/ Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1984 Effective …

Non-standard size or width Short Description: Orth foot non-stndard size/w Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date Added: January 1, 1984 Effective …

Foot, molded shoe plastazote (or similar) custom fitted, each Short Description: Shoe molded plastazote cust Coverage Code: Special coverage instructions apply Action Code: No maintenance for this code Date …