Correct Coding of Arizona-Type AFO
Linda Collins
11-10-2020
Blog
The DME MACs released an article with updated information about billing the Arizona-Type Ankle-Foot Orthosis.
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 hook and loop closure. L2820 is used only if a soft interface, either leather or other material, is provided.
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
You may find more information here: https://www.cgsmedicare.com/jc/pubs/news/2020/10/cope19279.html