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Orthotic coding for medicare

  1. Default Orthotic coding for medicare
    Clearnace Sale
    What is the medicare code for orthotics? i think its a G-Code.

  2. #2
    Look for the type of orthotic in your hcpcs book. Most of them begins with the letter l. Hope this helps.

  3. #3
    HCPC L3000 through L3030 for custom orthotics which are not covered by Medicare unless it is part of a medically necessary brace. Since they are not cover by Medicare they would need to be submitted with a GY modifier showing that the custom orthotics are statutorily excluded. If the shoe insert is for a diabetic and meet the guidelines for a diabetic insert then the HCPCP code will be A5512 or A5513 will need KX, LT, and RT modifier.
    Tammy Hulsey-Ferguson, CPC
    Past President AAPC Wichita, KS Local Chapter

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