HCPCS Code Section: HCPCS L Codes

Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf Short Description: Static or dynami afo …

Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, …

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 …

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 …

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 …

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 …

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 …

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, …

Below knee, plastic socket, joints and thigh lacer, sach foot Short Description: Plast socket jts/thgh lacer Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: …

Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf Short Description: Pneuma/vac walk boot pre ots Coverage Code: Carrier judgment Action Code: …