HCPCS Code Section: HCPCS L Codes

L4100

Replace leather cuff kafo, proximal thigh Short Description: Repl leath cuff kafo prox th Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

L4090

Replace metal bands kafo-afo, calf or distal thigh Short Description: Repl met band kafo-afo calf/ Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January …

L4080

Replace metal bands kafo, proximal thigh Short Description: Repl met band kafo-afo prox Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1986 …

L4070

Replace proximal and distal upright for kafo Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1986 Effective Date: January 1, 1996 Termination …

L4394

Replace soft interface material, foot drop splint Short Description: Replace foot drop spint Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1997 …

L4392

Replacement, soft interface material, static afo Short Description: Replace afo soft interface Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1997 Effective …

L4387

Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf Short Description: Non-pneum walk boot pre ots Coverage Code: Carrier judgment Action Code: No maintenance …

L4386

Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient …

L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot Short Description: Mold sckt ext knee shin sach Coverage Code: Carrier judgment Action Code: No maintenance …

L4370

Pneumatic full leg splint, prefabricated, off-the-shelf Short Description: Pneum full leg splnt pre ots Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …