Query: Code For Ortho-Wedge
Is there a specific code for an Ortho-Wedge
(example: http://www.brace4u.com/darco/ow%5B1%
5D.htm) or Ortho-Heel surgical shoes? I noticed
that the 2003 HCPCS has deleted both L3218 and
L3223 codes.
Should we be using L3260 for all ambulatory
surgical boots, or is there a more specific code
for the Ortho-Wedge or Ortho-Heel shoes? Thanks
Rebecca McGregor
Office Administrator
Simpsonville, SC
Codingline-L Response:
In my experience, all adult 'surgical' boots
are all coded exactly the same. In my opinion,
those surgical boots would include examples such
as Ortho-Wedge and Ortho-Heel Shoe. The code
which I find to be most widely accepted for these
items is L3260 (ambulatory surgical boot, each).
The only exceptions I can tell would be for
children’s surgical boots: L3208 (surgical boot,
each, infant); L3209 (surgical boot, each,
child); L3211 (surgical boot, each, junior).
[The only other code is L3265 which is for a
plastizote healing sandal]
I checked with SADMERC regarding the age limits
for infant, child and junior, but could not get
an answer. Since I have previously communicated
with the HCPCS coding manager at SADMERC, I will
e-mail her to attempt to get an answer and
additional clarification.
For my Medicare patients, I always charge them
for these shoes as they are not covered by
Medicare.
Paul Kesselman, DPM
Woodside, NY
