Browse HCPCS Level II 2020 Edition

HCPCS Level II Table of Contents

L2200 - L2397  Additions to Lower Extremity Orthosis: Shoe-Ankle-Shin-Knee

L2200
Addition to lower extremity, limited ankle motion, each joint
shortLimited ankle motion ea jnt
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2210
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint
shortDorsiflexion assist each joi
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2220
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint
shortDorsi & plantar flex ass/res
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2230
Addition to lower extremity, split flat caliper stirrups and plate attachment
shortSplit flat caliper stirr & p
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2232
Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only
shortRocker bottom, contact afo
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2240
Addition to lower extremity, round caliper and plate attachment
shortRound caliper and plate atta
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2250
Addition to lower extremity, foot plate, molded to patient model, stirrup attachment
shortFoot plate molded stirrup at
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2260
Addition to lower extremity, reinforced solid stirrup (scott-craig type)
shortReinforced solid stirrup
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2265
Addition to lower extremity, long tongue stirrup
shortLong tongue stirrup
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2270
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad
shortVarus/valgus strap padded/li
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalAnatomic Consideration
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
L2275
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
shortPlastic mod low ext pad/line
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalAnatomic Consideration
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
L2280
Addition to lower extremity, molded inner boot
shortMolded inner boot
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2300
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable
shortAbduction bar jointed adjust
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.02 Date of Service Edit: PolicyNature of Equipment
DME1.02 Date of Service Edit: PolicyNature of Equipment
L2310
Addition to lower extremity, abduction bar-straight
shortAbduction bar-straight
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH1.02 Date of Service Edit: PolicyNature of Equipment
DME1.02 Date of Service Edit: PolicyNature of Equipment
L2320
Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only
shortNon-molded lacer
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalAnatomic Consideration
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
L2330
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
shortLacer molded to patient mode
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalAnatomic Consideration
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
L2335
Addition to lower extremity, anterior swing band
shortAnterior swing band
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2340
Addition to lower extremity, pre-tibial shell, molded to patient model
shortPre-tibial shell molded to p
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2350
Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for 'ptb' 'afo' orthoses)
shortProsthetic type socket molde
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2360
Addition to lower extremity, extended steel shank
shortExtended steel shank
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2370
Addition to lower extremity, patten bottom
shortPatten bottom
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2375
Addition to lower extremity, torsion control, ankle joint and half solid stirrup
shortTorsion ank & half solid sti
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.02 Date of Service Edit: PolicyAnatomic Consideration
DME2.02 Date of Service Edit: PolicyAnatomic Consideration
L2380
Addition to lower extremity, torsion control, straight knee joint, each joint
shortTorsion straight knee joint
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH2.03 Date of Service Edit: ClinicalAnatomic Consideration
DME2.03 Date of Service Edit: ClinicalAnatomic Consideration
L2385
Addition to lower extremity, straight knee joint, heavy duty, each joint
shortStraight knee joint heavy du
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2387
Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint
shortAdd le poly knee custom kafo
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2390
Addition to lower extremity, offset knee joint, each joint
shortOffset knee joint each
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2395
Addition to lower extremity, offset knee joint, heavy duty, each joint
shortOffset knee joint heavy duty
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.02 Date of Service Edit: PolicyAnatomic Consideration
DME4.02 Date of Service Edit: PolicyAnatomic Consideration
L2397
Addition to lower extremity orthosis, suspension sleeve
shortSuspension sleeve lower ext
MUE
LocationValueAjudication IndicatorRationale
PRA0.03 Date of Service Edit: ClinicalCMS Policy
OPH4.03 Date of Service Edit: ClinicalAnatomic Consideration
DME4.03 Date of Service Edit: ClinicalAnatomic Consideration