Recommendation: Yes, you can train with AOPA coding experts and earn 12.5 CE credits, as well! Check out upcoming dates and register for the two-day AOPA Coding & Billing Seminar.

Orthotics - Lower Extremity

Question: Are Townsend AFOs and KAFOs similarly coded to the Oregon orthosis, because both companies offer carbon fiber construction?

Recommendation: This is difficult to answer, since there are a number of Townsend devices. However, L2755 would be acceptable for Townsend devices billed with the proper AFO/KAFO code.

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Question: How would you code the Spinal Solutions spiral carbon graphite AFO? What about Otto Bock’s off-the-shelf carbon graphite AFO? Or Ossur’s new carbon AFO that is similar to the Toe Off?

Recommendation: Code L1951 for all three. We would not recommend L1950, since these devices are not custom fabricated.

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Question: How would you recommend coding the Camp off-the-shelf check brace for genu-recurvatum?

Recommendation: Use L1850.

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Question: How would you code a custom silicone slipper-style prosthesis attached to a carbon graphite floor reaction AFO for a Chopart-level amputation?

Recommendation: The code would be L5020. If it is laminated with acrylic material, also use L5629.

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Question: What is the correct code for the Ossur Footplate tapered?

Recommendation: The correct code is L3031.

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Question: How do you code an Ossur AFO dynamic?

Recommendation: Use L1951.

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Question: How do I code for the Ossur 28U11 walk-on AFO?

Recommendation: Use L1951.

Orthotics - Upper Extremity

Question: Would codes L3700 or L3701 be appropriate to bill for a tennis elbow brace? The argument is that the air bladders are comparable to stays (L3700) and the brace is made out of neoprene (L3701).

Recommendation: Use L3999; however, this device may not be considered an orthotic device.

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Question: What is the appropriate code for an Innovation Sports Carp-X WHO?

Recommendation: Use L3914.

Spinal

Question: Is L1300 the most appropriate code for a Charleston Bending Brace? Also, can you add scoliosis additions to TLSO codes in the L0400 series?

Recommendation: For the Charleston Bending Brace, L1200 or L1300 would be appropriate. The AOPA Coding Committee does not recommend using scoliosis additions with the L0400 series TLSO codes, since these additions are specifically intended for use with scoliosis base codes.

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Question: What are the correct codes for the Cybertech body jacket and the Cybertech TLSO 817?

Recommendation: For the body jacket, use L1499, with L0999 for the closure mechanism. For the TLSO, use L046 and L0999 for the closure system.

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Question: How would you code custom CTOs or TOs?

Recommendation: Use L1499.

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Still have a coding & billing question? Contact AOPA expert Joe McTernan at (571) 431-0876 ext. 211 or JMcTernan @aopanet.org.