Orthopedic Shoe attached to an Orthosis

Orthopedic Shoe attached to an Orthosis

Boland P & O Center

10/2/2001

There has been some confusion about billing for and orthopedic shoe attached to an orthosis. We understand that L3224 & L3225 are to be used to bill Medicare for the shoes attached to the orthosis, but what about the other shoe which completes the pair? Is this shoe billed as L3224/3225 or is it billed a regular womens/mens shoe (L3215/3219)? We have had some cases where the shoe was billed as 1 - L3224 and 1-L3215 and the 3215 was denied by Medicare. We have heard cases from patients that the DME provider sends the patient to a shoe store to purchase their shoes and then the have them attached for them.

Any help would be greatly appreciated.

Stephanie