Cast Off Doubt About Coding for Castings
Question: We have a practitioner specializing in foot and ankle care. Until now, they have been referring patients to our therapy team for the creation of custom orthotic casts. However, they are now considering casting these molds themselves within the clinic. How should we code this service? AAPC Forum Participant Answer: Because the provider is going to be molding the castings, you should use S0395 (Impression casting of a foot performed by a practitioner other than the manufacturer of the orthotic). Remember: Always confirm the acceptance of S codes with your patient’s insurance provider before providing the service to the patient. For example, Medicare does not recognize S codes, which could potentially lead to non-reimbursement. Also, you should bill out orthotics castings at the time of service, and you should bill out the orthotics themselves, usually with L3000 (Foot, insert, removable, molded to patient model, ‘UCB’ type, Berkeley Shell, each) at the time the patient receives the inserts. You are able to bill separately for the right and left orthotic, if applicable, using modifiers RT (Right side) and LT (Left side). Keep in mind that unless orthotics are connected to a brace that is covered, Medicare will not provide coverage for them. Lindsey Bush, BA, MA, CPC, Production Editor, AAPC 
