L4631 – Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated

Long description

Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated

Short description

Afo, walk boot type, cus fab

Pricing indicator

38 Orthotics, prosthetics, prosthetic devices & vision services

Medicare coverage

C Carrier judgment – coverage decided by the Medicare contractor

BETOS category

D1F Prosthetic/Orthotic devices

Added

January 1, 2011

Last change

January 1, 2011 – No change

Nearby L codes

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• 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 by an individual with expertise
• L4387 – Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf
• L4392 – Replacement, soft interface material, static afo
• L4394 – Replace soft interface material, foot drop splint
• L4396 – 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, assembled, or otherwise customized to fit a specific patient by an individual with expertise
• L4397 – 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
• L4398 – Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf
• L5000 – Partial foot, shoe insert with longitudinal arch, toe filler
• L5010 – Partial foot, molded socket, ankle height, with toe filler
• L5020 – Partial foot, molded socket, tibial tubercle height, with toe filler
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• L5060 – Ankle, symes, metal frame, molded leather socket, articulated ankle/foot
• L5100 – Below knee, molded socket, shin, sach foot
• L5105 – Below knee, plastic socket, joints and thigh lacer, sach foot
• L5150 – Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot