03/30/2022

Correct Coding for Orthotics

Please advise appropriate coding for orthotics. l3000 or l3030. Is l3000 only used for ucb type orthotic? Thank you

Below are the key differences between HCPCS codes L3000 & L3030 when billing for orthotics:

L3000: This orthotic is created from a 3D model of the patient’s own limb (e.g. cast, foam mold, or digital imaging). This device has a molded heel cup and trim lines with substantial height to provide both medial and lateral directive forces to control the hind and fore foot, in addition to intrinsic or extrinsic posts designed to control foot motion. The code bundles inclusive, patient specific additions additions such as postings, padding and lesion or structure alterations.

L3030: This is formed directly with a heat source applied to the patient’s foot. When heat is applied, the shape of the unit will be altered to form to the unique structure of the patient’s foot, with intrinsic or extrinsic post to manage motion of the foot. The code bundles inclusive, patient specific additions additions such as postings, padding and lesion or structure alterations.