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.
Related Articles RSS Feed
Replacement of Pacemaker Generator
Viewed 12237 times since Thu, Mar 15, 2012
Transfusion
Viewed 73 times since Tue, Mar 29, 2011
Flap Closure
Viewed 4375 times since Tue, Jan 31, 2012
Complication coding
Viewed 1630 times since Fri, Feb 11, 2011
Transbronchial bx Modifier Issue
Viewed 2609 times since Tue, Jan 10, 2012
Excision Breast Tissue
Viewed 4623 times since Fri, Mar 25, 2011
Screening vs. Diagnostic Colonoscopy
Viewed 4210 times since Wed, Jul 27, 2011
Failed Placement of Infusaport
Viewed 2503 times since Tue, Dec 27, 2011
Modifier PT & 33
Viewed 3736 times since Thu, May 12, 2011
Cardioversion
Viewed 1694 times since Fri, Aug 17, 2012
Quorum Health Resources, LLC :: 105 Continental Place Brentwood, TN 37027 :: Phone: (615) 371-4506