Foot Orthoses Billing Guide (Click to Download) Custom Shoe Code Guide (Click to Download) AFO L- Code Guide (Click to Download)
Billing Codes for custom made foot orthoses:

L3000          L3010          L3020          L5000          A5511

 

Following is a list of currently acceptable insurance billing codes for custom made orthotics and a brief interpretation for your use. Please note, this is only a partial list. For a more complete listing you should refer to the orthotic billing code manual.

 

L3000

Foot insert, removable, molded to patient model. “UCB” Type, Berkeley Shell, each. Plastic device, molded over model of patient’s foot to provide control of the foot.

 

This code is used for prescription foot orthoses made of rigid or semi-rigid materials for the purpose of controlling the foot by improving foot function. This can include UCBL devices, modified UCB devices and all rigid or semi-rigid foot orthoses made from a model of the of the patient’s foot whether plaster, foam or electronic imaging. This code includes all billable fees for the orthoses including additions such as rearfoot or forefoot posting, padded top covers, soft tissue supplements, balance padding, lesion or structure accommodations and any other additions that may be required.

 

L3010

Foot insert, removable, molded to patient model, longitudinal and metatarsal support, each. A soft, semi-flexible or rigid device molded over a model of the patient’s foot and placed in the shoe to provide support under the longitudinal arch of the foot.

 

This code is used for a custom prescription foot orthoses made on a plaster, foam or electronic image of the foot where no corrections or balancing is performed, providing only longitudinal arch support and no attempt at foot control or improvement of function. Such devices would have a flat heel cup with no heel control, and no posting.

 

L3020

Foot insert, molded to patient model, longitudinal and metatarsal support, each. A device molded over a model of the patient’s foot and placed in the shoe to provide support under the ball of the foot.

 

This code is for a custom prescription orthoses made on a foam, plaster or electronic image mold of the foot where no corrections or balancing is performed, but additional support is added to enhance or relieve pressure to the transverse metatarsal arch and the longitudinal arch.

 

L5000

Partial foot, shoe insert with longitudinal arch, toe filler, each. The patients shoe must be included with the order to guarantee a proper fit.

 

    ICD9 Codes associated with L5000

 

    V49.71 - Amputation of the great toe

 

    V49.72 - Amputation of lesser digit

 

    V49.73 - Amputation of foot/partial foot

 

A5511

For diabetics only, custom molded from a model of patient’s foot, multiple density insert, custom fabricated, each.

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