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L3600 |
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Transfer of an orthosis from one shoe to another, caliper plate, existing
| short | Trans shoe calip plate exist |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure | | DME | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure |
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L3610 |
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Transfer of an orthosis from one shoe to another, caliper plate, new
| short | Trans shoe caliper plate new |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure | | DME | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure |
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L3620 |
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Transfer of an orthosis from one shoe to another, solid stirrup, existing
| short | Trans shoe solid stirrup exi |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure | | DME | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure |
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L3630 |
|
Transfer of an orthosis from one shoe to another, solid stirrup, new
| short | Trans shoe solid stirrup new |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure | | DME | 2.0 | 2 Date of Service Edit: Policy | Nature of Service/Procedure |
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L3640 |
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Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes
| short | Shoe dennis browne splint bo |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 1.0 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction | | DME | 1.0 | 2 Date of Service Edit: Policy | Code Descriptor / CPT Instruction |
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L3649 |
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Orthopedic shoe, modification, addition or transfer, not otherwise specified
| short | Orthopedic shoe modifica nos |
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Clinical: Data |
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