L-Code Foot Orthotic Clarification
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L-Code Foot Orthotic Clarification

Participating Organizations:

American Orthotic and Prosthetic Association (AOPA)

American Podiatric Medical Association (APMA)

Pedorthic Footcare Association (PFA)

 

The following language has been approved by the American Podiatric Medical Association (APMA), American Orthotic and Prosthetic Association (AOPA), and Pedorthic Footcare Association (PFA) after a series of meetings, the most recent having occurred on May 3, 2013.

L3000 -- Foot insert, removable, molded to patient model, UCB type, Berkeley shell, each

Guideline: Prescription Custom Fabricated Foot insert, each, removable.  This type of device is fabricated from a three dimensional model of the patient’s own foot (e.g. cast, foam impression, or virtual true 3-D digital image).  This type of orthotic is a functional device, (reducing pathological forces) which has a molded heel cup and trim lines with substantial height to provide both medial and lateral directive forces to control the hind and fore foot.   It may also have intrinsic or extrinsic posts designed to control foot motion.  This device is made of a sufficiently rigid material to control function and reduce pathological forces. HCPCS code L3000 includes additions such as postings, padded top covers, soft tissue supplements, balance padding and lesion or structure accommodations.  Other additions may be required as well.

L3010 -- Foot, insert, removable, molded to patient model, longitudinal arch support, each

Guideline: Prescription Custom Fabricated Foot insert, each, removable.  This type of device is fabricated from a three dimensional model of the patient’s own foot (e.g. cast, foam impression, or virtual true 3-D digital image).  This type of orthotic is an accommodative/functional device, which has minimal to no heel cup and is intended to control the forefoot through a longitudinal arch support. It may also have an intrinsic or extrinsic posts designed to control foot motion.  This device is made of a sufficiently rigid material to reduce pathological forces. HCPCS code L3010 includes additions such as postings, padded top covers, soft tissue supplements, balance padding and lesion or structure accommodations.  Other additions may be required as well.

L3020 -- Foot insert, molded to patient model, longitudinal/metatarsal support, each

Guideline: Prescription Custom Fabricated Foot insert, each, removable.  This type of device is fabricated from a three dimensional model of the patient’s own foot (e.g. cast, foam impression, or virtual true 3-D digital image).  This type of orthotic is an accommodative/functional device, which has minimal to no heel cup and is intended to control the forefoot through a Longitudinal Arch and metatarsal support. It may also have an intrinsic or extrinsic posts designed to control foot motion.   This device is made of a sufficiently rigid material to reduce pathological forces. HCPCS code L3020 includes additions such as postings, padded top covers, soft tissue supplements, balance padding and lesion or structure accommodations.  Other additions may be required as well.

L3030 -- Foot insert, removable, formed to patient foot, each

Guideline: Prescription Custom Fabricated Foot insert, each, removable.  This type of device is formed directly to the patient’s foot through the use of an external heat source. The heat source should sufficiently and permanently alter the shape of the device, activating a resin, or other method by which the shape of the device is sufficiently and permanently altered in order to provide continuous contact with the unique characteristics of the plantar aspect of the patient’s foot. It may also have an intrinsic or extrinsic post designed to control foot motion. This type of orthotic is an accommodative/functional device.  This device is made of sufficiently rigid material to control foot motion and or reduce pathological forces. HCPCS code L3030 includes additions such as postings, padded top covers, soft tissue supplements, balance padding and lesion or structure accommodations.  Other additions may be required as well.

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