Home » Categories » CPT Surgery/APC Coding

L3260 Heel Wedge Shoe


Question

Our Rehab wants the L3260 order for a pt patient-- I’m thinking this might be something the patient should acquire from a DME - would this be a covered item under Medicare or insurance delivered from the outpatient Physical Therapy department?

Answer

L3260 describes a surgical boot/shoe.  This code has a status indicator of "E" indicating that it is a noncovered supply on an outpatient claim.  If this code assignment is correct, you should obtain an ABN when this supply is issued to a Medicare patient.   This code assignment is questioned if you are trying to capture a Heel Wedge as L3340 or L3350 may be more accurate code options.  If one of these codes is assigned, it would be considered an covered orthotic and could be charged with one of these codes under revenue code 274.  Orthotics can be charged separately by hospitals under current Medicare guidelines.  A heel wedge does not fall into the category of DME.

Disclaimer: All articles intended for general consumption only and not as a recommendation for a specific situation. Readers should consult an official source (AHA, AMA, etc.) or a qualified attorney for specific legal guidance.
Attachments Attachments
There are no attachments for this article.
Comments Comments
There are no comments for this article. Be the first to post a comment.
Related Articles RSS Feed
CPT for Sympathetic Nerve Block of the Inferior Hypogastric Plexus?
Viewed 5431 times since Thu, May 19, 2011
Bariatric Procedures
Viewed 1249 times since Wed, Apr 6, 2011
Cataracts and Complications
Viewed 3028 times since Tue, Nov 16, 2010
Ports
Viewed 894 times since Tue, Jul 12, 2011
Non-Incisional Foreign Body Removal
Viewed 2178 times since Tue, Sep 25, 2012
EGD with Foreign Body Removal Esophagus
Viewed 4610 times since Thu, Apr 21, 2011
Nasal Packing, Initial or Subsequent
Viewed 3835 times since Fri, Jul 22, 2011
Polyp Removal With Monopolar Cautery
Viewed 1753 times since Tue, Nov 16, 2010
ED procedure
Viewed 1052 times since Tue, Nov 29, 2011
Conscious Sedation
Viewed 8 times since Tue, Nov 16, 2010
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506