HCPCS Service Codes - Lump sum purchase of DME, prosthetics, orthotics

HCPCS Codes for Lump sum purchase of DME, prosthetics, orthotics

• L1820

  Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1821

  Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf

• L1830

  Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf

• L1831

  Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment

• L1832

  Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1833

  Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf

• L1834

  Knee orthosis, without knee joint, rigid, custom fabricated

• L1836

  Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf

• L1840

  Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated

• L1843

  Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1844

  Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated

• L1845

  Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1846

  Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated

• L1847

  Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1848

  Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf

• L1850

  Knee orthosis, swedish type, prefabricated, off-the-shelf

• L1851

  Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

• L1852

  Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf

• L1860

  Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk)

• L1900

  Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated

• L1902

  Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf

• L1904

  Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated

• L1906

  Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf

• L1907

  Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated

• L1910

  Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment

• L1920

  Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated

• L1930

  Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment

• L1932

  Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1933

  Ankle foot orthosis, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, off-the-shelf

• L1940

  Ankle foot orthosis, plastic or other material, custom fabricated

• L1945

  Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated

• L1950

  Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated

• L1951

  Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

• L1952

  Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, off-the-shelf

• L1960

  Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated

• L1970

  Ankle foot orthosis, plastic with ankle joint, custom fabricated

• L1971

  Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment

• L1980

  Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated

• L1990

  Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar 'bk' orthosis), custom fabricated

• L2000

  Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), custom fabricated

• L2005

  Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated

• L2006

  Knee ankle foot device, any material, single or double upright, swing and stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated

• L2010

  Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'ak' orthosis), without knee joint, custom fabricated

• L2020

  Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar 'ak' orthosis), custom fabricated

• L2030

  Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar 'ak' orthosis), without knee joint, custom fabricated

• L2034

  Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated

• L2035

  Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment

• L2036

  Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated

• L2037

  Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated

• L2038

  Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated