Responses-L codes for Cam Walkers

Responses-L codes for Cam Walkers

Hello List members: I posted a question asking for the appropriate L codes
to use for Cam Walkers. Thanks to all who responded!

The very first to respond was Karyn Schibanoff of AOPA. She told me that AOPA
is working on a master list of recommended L codes (which is quite an
undertaking) which will be in the in the works for a while longer.

Here is what AOPA recommends:

Boot-type Walkers

CAM Walkers
Pneumatic
Air C.A.M. Walker (pneumatic version) adjustable ankle
L4360 Pneumatic walking splint, e.g. aircast
L2220 x 2 Addition to lower extremity, dorsiflexion and plantar
flexion assist/resist, each joint

Air Castaway Walker (pneumatic version) fixed ankle
L4360 Pneumatic walking splint, e.g. aircast

Non-pneumatic
C.A.M. Walker (non-pneumatic version) adjustable ankle
L2999 Non-pneumatic similar to L4360
L2220 x 2 Addition to lower extremity, dorsiflexion and plantar
flexion assist/resist, each joint

Castaway Walker (non-pneumatic version) fixed ankle
L2999 Non-pneumatic similar to L4360

CROW Walker
L1960 AFO, posterior solid ankle, molded to patient model, plastic
L2340 Addition to lower extremity, pretibial shell, molded to patient
model
L2820 Addition to lower extremity orthosis, soft interface for molded
plastic, below knee section
L3020 Foot insert, removable, molded to patient model,
longitudinal/metatarsal support, each
L2999 rocker sole

if appropriate
L2350 Addition to lower extremity, prosthetic type, (BK) socket, molded to
patient model, (used for “PTB,” “AFO” orthoses)

Karyn Schibanoff
Reimbursement Specialist
AOPA


Here are the other responses I've received and have not included names.

I use L2112 for the ROM ankle type and add the joints L2200
I use L2114 for a dual post, solid type
& the clamshell off the shelf L2116

Depending on the use, normally the are used to treat Fx's. L2114 is the code
for a fx boot/AFO type orthosis.

L2112 OR L2114 OR L2116 These are the suggested codes given by suppliers
of cam walkers and other devices like them. As usual, the phrase code what
you do; do what you code really rings true.

We have found that code L2112 best suits the Cam Walker descripition.

I believe we use L2112-soft tiibial Fx orthosis + code for adjustable ankle
joints if used.

Try L2114 and L2116 also for pneumatic CAM walkers L4360.

I use L2112 and an appropriate fee I do not add on for DAAJ because they
come with it .

Some say to use Aircast walker plus joints, I am also curious about what to
do. I wish there were more codes so we did not have to guess.

A former office manager of mine queried Medicare about this a few years ago.
She was told to use either the soft or semi-rigid fracture code for walking
boots. I'm at home and don't have the exact codes in front of me, but it
seems it was L2112 or L2114. If we needed something rigid, we would use a
L2116.

We use the L-code for a semi-rigid tibial fracture orthosis.

I'd be very interested in learning what the general concessus is from other
respondents to your question. I brought the whole issue to the SADMERC to get
their advice, I'm sorry I even asked. I sent them product literature (not
prices) on a half dozen or so of the numerous models on the market I
explained the likeness and differences and how they could fit this L code or
another. Simply put, I laid out the whole issue for them to address and
advised them that there was a tremendous amount of these being dispensed with
a variety of codes being used. I pointed out that some Mfg.'s were putting
them in docs offices and they were being billed by a central billing company
as custom made fracture braces.(I know this is true)
      What I got for all my effort was a Medicare audit the very next week
wanting to see charts of patients that had received pre fab tibial fracture
braces from my facility. The following week I received a formal response to
my letter which said that all of the devices I presented should be billed as
a NOC code. What BS!!!
        The HCFA are being screwed by the MFGS that leave this crap in the
docs offices, and when an honest slob like you or me try to get advice on how
to dispense them properly we're going to get crucified. I don't know about
you but billing something as a NOC to Medicare that is routinely provided is
a bad idea.
Unsigned