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Ankle-Foot Orthoses – Arizona-Type – Correct Coding – Revised

Arizona AFO is a company that manufactures a line of custom fabricated ankle-foot orthoses. Other companies manufacture similar products. The Pricing, Data Analysis, and Coding (PDAC) contractor has recently reviewed the Arizona AFO line of products and determined the appropriate HCPCS codes to be used when billing for these and similar items.

For the Arizona Short and Arizona Tall, or similar custom fabricated braces, only the following codes should be used:
L1940   Ankle foot orthosis, plastic or other material, custom fabricated
L2330   Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820   Addition to lower extremity orthosis, soft interface for molded plastic below knee section

L2330 is used whether the closure is a lacer closure or a Velcro closure. L2820 is used only if a soft interface, either leather or other material, is provided.

This section has been revised from the original article, titled Ankle-Foot Orthoses – Arizona Type – Correct Coding, posted on December 4, 2008. DMECS has been updated to reflect any applicable changes.

For the Arizona Extended and the Arizona Unweighting or similar custom fabricated braces, only the following codes should be used:
L1960   Ankle foot orthosis, posterior solid ankle, plastic, custom-fabricated
L2330   Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820   Addition to lower extremity orthosis, soft interface for molded plastic below knee section

The following codes must not be used for these orthoses:
L2275   Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined
L2280   Addition to lower extremity, molded inner boot

For the Arizona Partial Foot model or similar orthosis, use codes:
L1940   Ankle foot orthosis, plastic or other material, custom-fabricated
L2330   Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820   Addition to lower extremity orthosis, soft interface for molded plastic, below knee section
L5000   Partial foot, shoe insert with longitudinal arch, toe filler.

Suppliers, manufacturers and distributors are reminded to check the product listing on Product Classification List located on Durable Medical Equipment Coding System (DMECS), if there are any changes they are to notify the PDAC.

Suppliers who have incorrectly coded these orthoses should submit a voluntary refund to the DME MAC.

For questions about correct coding, contact the PDAC Contact Center at (877) 735-1326 during the hours of 8:30 a.m. to 4:00 p.m. CT, Monday through Friday, or e-mail the PDAC by completing the DME PDAC Contact Form located on the PDAC website: https://www.dmepdac.com/.

Date Posted 11/15/11, Updated 11/22/11