L3020 & L3000 for Medicare

L3020 & L3000 for Medicare

Darya Shahrokhi

8/18/2020

Thanks for all of you who emailed clear answers. Some of you asked me to share responses:
questions was: If Medicare pays for L3020 or L3000

Answers:
Medicare pays for those codes just if the insert(s) attache(s) to the brace. Here is how they wording:

Inserts and other shoe modifications (L3000, L3001, L3002, L3003, L3010, L3020, L3030, L3031, L3040, L3050, L3060, L3070, L3080, L3090, L3100, L3140, L3150, L3160, L3170, L3300, L3310, L3320, L3330, L3332, L3334, L3340, L3350, L3360, L3370, L3380, L3390, L3400, L3410, L3420, L3430, L3440, L3450, L3465, L3470, L3480, L3485, L3500, L3510, L3520, L3550, L3560, L3570, L3580, L3590 and L3595) are covered if they are on a shoe that is an integral part of a covered brace and if they are medically necessary for the proper functioning of the brace. Shoes and related modifications, inserts, heel/sole replacements or shoe transfers billed without a KX modifier will be denied as noncovered because coverage is statutorily excluded.”

Thanks again.
Darya
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