AFO L-code & reimbursement guide 2022

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