ORTHOTIC CODING GUIDE

Lower Extremity Orthoses
(Listed in Alphabetical Order)

ACL De-Rotational Frame Style Knee Brace:  L1845 (Use L1846 if Custom)
AFO (Ankle Foot Orthosis), Custom Plastic:  L1960 (+More)​
AFO (Ankle Foot Orthosis), Custom Plastic with Joints:  L1970 (+More)​
AFO (Ankle Foot Orthosis), Carbon Fiber:  L1932 (+More)​
Arizona AFO (Ankle Foot Orthosis), Leather Gauntlet:  L1940 (+More)
Ankle Stirrup (Air Stirrup):  L4350
Cam-Walker (Pneumatic), Short or Tall:  L4360 (Use L4361 if "Off the Shelf")
CROW Walker (Charcot Reducing Orthotic Walker):  L4631 (+More)
Fracture Boot (Pneumatic), Short or Tall:  L4360 (Use L4361 if "Off the Shelf")
Hip Abduction Brace:  L1686 (+More)
KAFO (Knee Ankle Foot Orthosis):  L2036 (+More)
Knee Brace, De-Rotational Frame Style for ACL/PCL/MCL/LCL :  L1845 (Use L1846 if Custom)
Knee Brace, Neoprene w/ Hinges:  L1820
Knee Brace, Neoprene Sleeve:  Not a Covered Benefit Usually (Cash Pay)
Knee Brace, OA (Osteoarthritis) Unloader, Double Upright:  L1845 (Use L1846 if Custom)
Knee Brace, OA (Osteoarthritis) Unloader, Single Upright:  L1843 (Use L1844 if Custom)
Knee Brace w/ Patellar Tracking:  L1820 + L2395
Knee Brace w/ ROM Joints (Donjoy Playmaker or Equivalent):  L1832
Knee Immobilizer:  L1830
Lace-Up Figure 8 Ankle Brace:  L1906
LCL De-Rotational Frame Style Knee Brace:  L1845 (Use L1846 if Custom)
MCL De-Rotational Frame Style Knee Brace:  L1845 (Use L1846 if Custom)
Molded Leather Gauntlet AFO:  L1940 (+More)
Night-Splint:  L4396 (Use L4397 if "Off the Shelf")
OA (Osteoarthritis) Unloader Knee Brace, Double Upright:  L1845 (Use L1846 if Custom)
OA (Osteoarthritis) Unloader Brace, Single Upright:  L1843 (Use L1844 if Custom)
Patellar Tracking Knee Brace:  L1820 + L2395
PCL De-Rotational Frame Style Knee Brace:  L1845 (Use L1846 if Custom)
Plantar Fasciitis Splint:  L4396 (Use L4397 if "Off the Shelf")
Post-Op ROM (Range of Motion) Knee Brace:  L1832
Richie Brace:  L1970 (+More)
Walking Boot (Pneumatic), Short or Tall:  L4360 (Use L4361 if "Off the Shelf")

Upper Extremity Orthoses
(Listed in Alphabetical Order)

Carpal Tunnel Splint:  L3908
Elbow ROM (Range of Motion) Brace with Hinges:  L3760
Resting Hand Splint:   L3807 (Use L3809 if "Off the Shelf")
Shoulder Immobilizer (Ultrasling or Equivalent):  L3670
Thumb Abduction Splint:  L3923
Thumb Spica:  L3807 (Use L3809 if "Off the Shelf")
Ultrasling Shoulder Immobilizer:  L3670
Wrist Splint:  L3908

Fracture Management
(Listed in Alphabetical Order)

Ankle Fracture Boot:  L4360
Humeral Fracture Brace:  L3980 (+More)
Humeral Fracture Brace with Deltoid Extension:  L3980 (+More)
Malleolus Fracture:  L4360
Midfoot Fracture:  L4360
Tibial Fracture Brace with Footplate (Sarmiento Style):  L2116 (+More)
Tibial Plateau Fracture (ROM Knee Brace):  L1832
Ulnar Fracture Brace:  L3982 (+More)
Active Life provides coding recommendations as a courtesy, and assumes no responsibility or liability for the provider's coding decisions.  The responsibility for accurate coding lies solely with the provider authorizing treatment or actively treating the patient.  Active Life's coding recommendations are subject to change at any time, and are generated using information provided by manufacturers and other public or private agencies, which are then reviewed and compiled by Active Life.