New AFO definition from CMS

Christopher Moore

Description

Title:

New AFO definition from CMS

Creator:

Christopher Moore

Date:

12/30/2011

Text:

Happy New Year's everyone,

I saw a dme update today from Noridian that included a new to me parameters
on the L1960 code with regards to height and the L2340 for length.

L1960 ANKLE FOOT ORTHOSIS, POSTERIOR SOLID ANKLE, PLASTIC, CUSTOM-FABRICATED

An Ankle Foot Orthosis (AFO) provides ankle control for patients with
musculoskeletal or neuromuscular dysfunction. The AFO is designed to
provide rigid immobilization of the ankle-foot complex in the sagittal,
coronal, and transverse planes. The custom fabricated solid ankle AFO can
be constructed from thermosetting materials, thermoplastics, or composite
type materials. The proximal boarder of an Ankle Foot Orthosis (L1960) *shall
extend to a height no greater than 1.5 inches distal to the apex of the
head of the fibula.*
<URL Redacted>

1.5 as the max height allowable seems a bit short to me, especially in
more complicate cases (tone, knee involvement, etc).

Similarly this update also included restrictions on how low a pretibial
shell can extend.

L2340 ADDITION TO LOWER EXTREMITY, PRE-TIBIAL SHELL, MOLDED TO PATIENT MODEL

A pre-tibial shell, custom fabricated, provides a rigid overlapping
interlocking anterior tibial control *between the tibial tuberosity to a
point no greater than 3 inches proximal to the medial malleolus*. The
pre-tibial shell can be constructed from thermosetting materials,
thermoplastics, or composite type materials.

I called to verify it wasn't a typo, seeing as they have misspellings in
the definition it seemed plausible, the PDAC operator verified the
definition. Any thoughts?


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*Christopher Moore L/CPO*

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Citation

Christopher Moore, “New AFO definition from CMS,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 26, 2024, https://library.drfop.org/items/show/233118.