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 L3020.
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.
L3020: This device is far less corrective than the L3000 device but still must be fabricated from raw materials as does L3000 and L3010. In addition to retaining all the properties of the L3010 device, the L3020 possesses an additional supportive mechanism in the metatarsal area. That is the shell must be shaped properly to provide additional support to this area. A simple addition of a metatarsal pad to the area may not distinguish an L3020 from an L3010.There are no additional HCPCS codes to describe additions such as postings, padded top covers, soft tissue supplements, balance padding and lesion or structure accommodation.
The last installment of documenting custom foot orthotics will detail proper completion of the claim form for foot orthotics.
