The last four installments in this forum dealt with the three steps of required documentation for reimbursement for custom foot orthotics and L3000. To summarize those steps were proper clinical documentation of medical necessity to meet the merits of the third-party payer’s policy, the required elements of the fabrication/prescription process and most recently the fitting/adjustment and dispensing of the device and what type of device meets the requirements of an L3000.
This installment will discuss the proper documentation of another common foot orthotic which may meet the merits of L3010.
As was noted in the last installment of this column the HCPCS code set for custom fabricated orthotics were developed in the 1960’s prior to modern theory of biomechanics, and current materials and fabrication processes.
L3010: This device is far less corrective than the aforementioned L3000 device but still must be fabricated from raw materials as does L3000. Devices meeting the L3010 requirement are made of sufficiently strong enough materials to correct pathological forces. However, because they have an insufficient heel cup depth (<10mm) they have reduced potential to be as fully corrective in the rear foot as compared to an L3000 device. The L3010 device retains the potential to control the forefoot through a longitudinal arch support. As with the L3000 device it may also have intrinsic or extrinsic posts designed to control foot motion. At the present time, there are no additional HCPCS codes to describe additions such as postings, padded top covers, soft tissue supplements, balance padding and lesion or structure accommodations.
