AFO L-code & reimbursement guide 2022
AFO L-code & reimbursement guide 2022
Model
BILLABLE CODES & DESCRIPTIONS
REIMBURSMENT CEILING
TurboMed XTERN
L1951 - Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment
L1951 - $1055.35
L2820 - Addition to lower extremity orthosis, soft interface for molded plastic, below knee section.
L2820 - $114.22
Richie Brace® Standard
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
Richie Brace® Restricted Ankle Pivot
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
Richie Brace® Dynamic Assist
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2210 Tamarac dorsi-assist ankle joints (priced ea) - 2 hinges per brace
L2210 - $88.41
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
Richie AeroSpring Brace System®
L1932 - Afo rig ant tib prefab tcf
L1932 - $1121.37
L3000 - Ft insert ucb berkeley shell
L3000 - $394.75
Model: ACTIVE
BILLABLE CODES & DESCRIPTIONS
REIMBURSMENT CEILING
A100 - Leaf Spring
L1960 - AFO Solid Ankle, Molded to Patient Model, Solid Stirrup
L1960 - $729.06
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
A200 - Tamarack Free Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
A200L - Tamarack Free Motion Calf Lacer
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
A250 - Overlap Free Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
A300 - Tamarack Dorsi-Assist
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2210 - Dorsi-Flexion Assist Each Joint
L2210 - $88.41
L2210 - Dorsi-Flexion Assist Each Joint
L2210 - $88.41
A400 - Meridian Range Of Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2200 - Addition To Lower Extremity, Limited Ankle Motion, Each Joint
L2200 - $62.53
L2200 - Addition To Lower Extremity, Limited Ankle Motion, Each Joint
L2200 - $62.53
Model: GAUNTLET
BILLABLE CODES & DESCRIPTIONS
REIMBURSMENT CEILING
G100 - Short
L1940 - AFO, Molded to Patient Model
L1940 - $650.48
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
G120 - Standard
L1940 - AFO, Molded to Patient Model
L1940 - $650.48
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
G140 - Tall
L1940 - AFO, Molded to Patient Model
L1940 - $650.48
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
G200 - Tamarack Free Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
G250 - Overlapping Articulating Gauntlet
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
G300 - Tamarack Dorsi-Assist
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
L2210 - Dorsi-Flexion Assist Each Joint
L2210 - $88.41
L2210 - Dorsi-Flexion Assist Each Joint
L2210 - $88.41
G400 - Meridian Range Of Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
L2200 - Addition To Lower Extremity, Limited Ankle Motion, Each Joint
L2200 - $62.53
L2200 - Addition To Lower Extremity, Limited Ankle Motion, Each Joint
L2200 - $62.53
G600 - Leather Partial Foot
L1960 - AFO Solid Ankle, Molded to Patient Model, Solid Stirrup
L1960 - $729.06
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
L5000 - Arch Toe Filler
L5000 - $708.02
G700 - G-Flex
L1940 - AFO, Molded to Patient Model
L1940 - $650.48
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
G800 - Balance Brace
L1940 - AFO, Molded to Patient Model
L1940 - $650.48
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $114.22
L2330 - Addition To Lower Extremity, Lacer Molded to Patient Model, for Custom Fabricated Orthosis Only
L2330 - $516.47
Model: TRADITIONAL
BILLABLE CODES & DESCRIPTIONS
REIMBURSMENT CEILING
T100 - Leaf Spring
L1960 - AFO Solid Ankle, Molded to Patient Model, Solid Stirrup
L1960 - $729.06
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
T150 - Solid Ankle
L1960 - AFO Solid Ankle, Molded to Patient Model, Solid Stirrup
L1960 - $729.06
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
T200 - Tamarack Free Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
T300 - Tamarack Dorsi-Assist
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2210 - Dorsi-Flexion Assist Each Joint
L2210 - $88.41
L2210 - Dorsi-Flexion Assist Each Joint
L2210 - $88.41
T400 - Meridian Range Of Motion
L1970 - Ankle Foot Orthosis, Plastic with Ankle Joint, Custom Fabricated
L1970 - $935.93
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2200 - Addition To Lower Extremity, Limited Ankle Motion, Each Joint
L2200 - $62.53
L2200 - Addition To Lower Extremity, Limited Ankle Motion, Each Joint
L2200 - $62.53
Model: CROW
BILLABLE CODES & DESCRIPTIONS
REIMBURSMENT CEILING
C100 - Traditional CROW
L4631 - AFO, Walking Boot Type, Varus/Valgus Correction, Rocker Bot tom, Anterior Tibial Shell, Soft interface, Custom Arch Support, Plastic or Other Material, Includes Straps And Closure, Custom Fabricated
L4631 - $1,938.05
C200 - Tundra Walker
L1960 - AFO Solid Ankle, Molded to Patient Model, Solid Stirrup
L1960 - $670.70
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $105.08
L2280 - Addition to Lower Extremity, Molded Inner Boot
L2280 - $114.22
L2232 - Rocker Bottom for Total Contact AFO
L2232 - $122.98
L3010 - Addition to Custom AFO, Removable Molded to Patient Model Longitudinal/Metatarsal Foot Insert
L3010 - $218.98
C250 - Tundra Sandal
L1960 - AFO Solid Ankle, Molded to Patient Model, Solid Stirrup
L1960 - $670.70
L2275 - Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
L2275 - $164.96
L2820 - Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
L2820 - $105.08
L2280 - Addition to Lower Extremity, Molded Inner Boot
L2280 - $114.22
L2232 - Rocker Bottom for Total Contact AFO
L2232 - $122.98
POSSIBLE ADDITION CODES
CODE
DESCRIPTION
REIMBURSMENT CEILING
L2270
Addition to Lower Extremity Orthosis, Varus/Valgus Correction - TStrap
$70.64
L2275
Addition to Lower Extremity Orthosis, Varus/Valgus Correction, Plastic Modification
$164.96
L2820
Addition to Lower Extremity Orthosis, Soft Interface for Molded Plastic, Below Knee Section
$114.22
L2350
Addition to Lower Extremity Orthosis, Prosthetic Type, Socket, Molded to Patient Model
$1,172.01