04/12/2022

Dispensing Diabetic Shoes for Amputee

I have a patient who had a below knee amputation on right side. She was measured for diabetic shoes for her left foot and prosthetic right foot. What is the proper way to code right shoe? Is it A5500 as well?

If a patient is getting diabetic shoes dispensed and has one limb amputated, a provider would still bill for one unit of HCPCS code A5500 for each side. The difference in this circumstance is that diabetic shoe inserts (which would be billed under HCPCS code A5513 or A5514) would only be billed on the side where the patient does not have an amputation. In terms of modifiers, the same site modifiers would be used to distinguish between the left and right sides for the shoes and inserts. The number of units between the procedure codes would also be the same- one unit for each shoe, and three units for the side inserts are dispensed on.