ASSISTIVE TECHNOLOGY BILLING CODES
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1 ATTACHMENT 6 ASSISTIVE TECHNOLOGY BILLING CODES Please monitor the EI website at for changes to the Assistive Technology Code Table. 57
2 A4636 A4637 A9300 E0110 E0111 E0130 E0135 E0141 E0142 E0143 E0144 E0146 E0153 E0154 E0155 ASSISTIVE TECHNOLOGY BILLING CODES Replacement, handgrip, cane, crutch, or walker, each Replacement, tip, cane, crutch, walker, each Exercise equipment, (i.e., therapy ball, roll, bolster, any size) Computer access, software Miscellaneous DME supply, accessory, and/or service component of another HCPCS code (i.e. Weighted vest, any type) Switch activated device Switch, battery adapter Weighted blanket, any size Weights, miscellaneous Crutches, forearm, includes crutches of various materials, adj or fixed, pair, complete Crutch, forearm, includes crutches of various materials, adj or fixed, each, complete Walker, rigid pickup, adjustable/fixed, each Walker, folding (pickup), adj or fixed height Walker, rigid wheeled without seat Rigid walker, wheeled, with seat Folding walker, wheeled, without seat Enclosed, framed folding walker, wheeled with posterior seat Folding walker, wheeled, with seat Platform attachment, forearm crutch, each Platform attachment, walker, each Wheel attachment, rigid pickup walker, per pair E0158 Leg extensions for walker, per set of four (4) E0247 E0248 E1802 E1902 K0113 K0541 Tub stool or bench Temporary code (feeder seats, positioning chairs) AFO, addition, foot/calf strap, each (therapeutic listening programs) Durable Medical Equipment, NEC Posture control seat for floor sitting and feeding, any size Walker, pelvic stabilizer attachment Wedge, floor therapy Dynamic adjustable forearm, pronation/supination device, includes soft interface material Communication board, non-electronic augmentative or alternative communication device (PECS, eye-comm. board, boardmaker) Trunk support device, vest type, without inner frame, pre, Benik, only Speech generating device, digitized speech, prerecorded messages, <=8 min recording time (Twin talk) 58
3 K0542 K0544 K0546 K0547 L0120 L0984 L1500 L1510 L1520 L1600 L1610 L1620 L1630 L1640 L1650 L1660 L1680 L1690 L1800 L1810 L1830 L1860 L1901 L1902 L1904 L1920 L1930 L1930 L1940 L1940 L1945 L1950 Speech generating device, digitized speech, prerecorded messages, >8 min recording time (Dynavox, Macaw, Step by Step, E-talk) Speech generating device, synthesized speech, permitting multi methods of message formation and multi methods of device access Accessory for speech generating device, mounting system Accessory for speech generating device, NOC (overlay, keyguard) Collar, flexible, nonadjustable (foam collar) Spinal orthosis, protective body sock THKAO, mobility frame (Newington, parapodium types) THKAO, standing frame, with or without tray and accessories THKAO, swivel walker HO, abduction control of hip joints, flexible, Frejka type with cover, pre, F&A HO, abduction control of hip joints, flexible, (Frejka cover only), pre, F&A HO, abduction control of hip joints, semi-flexible, (Pavlik harness), pre, F&A HO, abduction control of hip joints, semi-flexible, (Von Rosen type), custom HO, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom HO, abduction control of hip joints, static, adjustable (Ilfled type), pre, F&A HO, abduction control of hip joints, static, plastic, pre, F&A HO, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (Ranch hip action type), custom Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, pre, F&A (SWASH) KO, elastic with stays, pre, F&A KO, elastic with joints, pre, F&A KO, immobilizer, canvas longitudinal, pre, F&A KO, modification of supracondylar prosthetic socket, custom Ankle orthosis, elastic, pre, F&A (e.g., neoprene, lycra) AFO, ankle gauntlet, pre, F&A AFO, molded ankle gauntlet, custom AFO, single upright with static or adjustable stop, custom AFO Pre AFO, plastic or other material, pre, F&A AFO, plastic or other material, custom SMO AFO, molded to patient model, plastic, rigid anterior tibial section (floor reaction), custom AFO, spiral, (IRM type), plastic, custom 59
4 L1960 L1970 L1980 L1990 L2000 L2010 L2020 L2030 L2035 L2036 L2037 L2038 L2040 L2050 L2060 L2070 L2080 L2090 L2200 L2210 L2220 L2230 L2240 L2250 L2260 L2265 L2270 L2275 L2280 L2300 AFO, posterior solid ankle, plastic, custom AFO, plastic, with ankle joint, custom AFO, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar "BK" orthosis), custom AFO, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar "BK" orthosis), custom KAFO, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar "AK" orthosis), custom KAFO, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar "AK" orthosis), without knee joint, custom KAFO, double upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar "AK" orthosis), custom KAFO, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar "AK" orthosis), without knee joint, custom KAFO, full plastic, static (pediatric size), pre, F&A KAFO, full plastic, double upright, free knee, custom KAFO, full plastic, single upright, free knee, custom KAFO, full plastic, without knee joint, multiaxis ankle, (Lively orthosis or equal), custom HKAFO, torsion control, bilateral rotation straps, pelvic band/belt, custom HKAFO, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom HKAFO, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/belt, custom HKAFO, torsion control, unilateral rotation straps, pelvic band/belt, custom HKAFO, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom HKAFO, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/belt, custom Addition to lower extremity, limited ankle motion, each joint Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint Addition to lower extremity, split flat caliper stirrups and plate attachment Addition to lower extremity round caliper and plate attachment Addition to lower extremity, foot plate, molded to patient model, stirrup attachment Addition to lower extremity, reinforced solid stirrup Addition to lower extremity, long tongue stirrup Addition to lower extremity, varus/valgus correction ("t") strap, padded/lined or malleolus pad Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined Addition to lower extremity, molded inner boot Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable 60
5 L2310 L2320 L2330 L2335 L2340 L2350 L2360 L2370 L2375 L2380 L2405 L2415 L2425 L2430 L2435 L2580 L2600 L2622 L2624 L2627 L2628 L2630 L2640 L2650 L2660 L2670 L2680 L2760 L2768 L2770 L2785 L2795 L2800 L2810 Addition to lower extremity, abduction bar, straight Addition to lower extremity, nonmolded lacer Addition to lower extremity, lacer molded to patient model Addition to lower extremity, anterior swing band Addition to lower extremity, pretibial shell, molded to patient model Addition to lower extremity, prosthetic type, (BK) socket, molded to patient model, (used for "PTB," "AFO" orthosis) Addition to lower extremity, extended steel shank Addition to lower extremity, Patten bottom Addition to lower extremity, torsion control, ankle joint and half solid stirrup Addition to lower extremity, torsion control, straight knee joint, each joint Addition to knee joint, drop lock, each joint Addition to knee lock with integrated release mechanism (ball, cable, or equal), any material, each joint Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint Addition to knee joint, ratchet lock for active and progressive knee extension, each joint Addition to knee joint, polycentric joint, each joint Addition to lower extremity, pelvic control, pelvic sling Addition to lower extremity, pelvic control, hip joint, Clevis type, or thrust bearing, free, each Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables Addition to lower extremity, pelvic control, band and belt, unilateral Addition to lower extremity, pelvic control, band and belt, bilateral Addition to lower extremity, pelvic and thoracic control, gluteal pad, each Addition to lower extremity, thoracic control, thoracic band Addition to lower extremity, thoracic control, paraspinal uprights Addition to lower extremity, thoracic control, lateral support uprights Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth) Orthotic side bar disconnect device, per bar Addition to lower extremity orthosis, any material, per bar or joint Addition to lower extremity orthosis, drop lock retainer, each Addition to lower extremity orthosis, knee control, full kneecap Addition to lower extremity orthosis, knee control, kneecap, medial or lateral pull Addition to lower extremity orthosis, knee control, condylar pad 61
6 L2820 L2830 L2860 L2999 L3000 L3001 L3002 L3003 L3010 L3020 L3030 L3040 L3050 L3060 L3070 L3080 L3090 L3140 L3150 L3170 L3201 L3202 L3204 L3206 L3212 L3213 L3257 L3300 L3310 L3320 L3332 L3350 L3380 L3580 L3700 L3701 Addition to lower extremity orthosis, soft interface for molded plastic, below knee section Addition to lower extremity orthosis, soft interface for molded plastic, above knee section Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism, each Lower extremity orthosis, NOS Foot insert, removable molded to patient model, "UCB" type, berkely shell, each Foot insert, removable, molded to patient, Spenco, each Foot insert, removable, molded to patient model, Plastazote or equal, each Foot insert, removable, molded to patient model, silicone gel, each Foot insert, removable, molded to patient model, longitudinal arch support, each Foot insert, removable, molded to patient model, longitudinal/metatarsal support, each Foot insert, removable, formed to patient foot, each Foot, arch support, removable, premolded, longitudinal, ea Foot, arch support, removable, premolded, metatarsal, each Foot, arch support, removable, premolded, longitudinal/metatarsal, each Foot, arch support, nonremovable, attached to shoe, longitudinal, each Foot, arch support, nonremovable, attached to shoe, metatarsal, each Foot, arch support, nonremovable, attached to shoe, longitudinal/metatarsal, each Foot, abduction rotation bar, including shoes Foot, abduction rotation bar, without shoes Foot, plastic heel stabilizer Orthopedic shoe, oxford with supinator or pronator, infant Orthopedic shoe, oxford with supinator or pronator, child Orthopedic shoe, hightop with supinator or pronator, infant Orthopedic shoe, hightop with supinator or pronator, child Benesch boot, pair infant Benesch boot, pair child Orthopedic footwear, additional charge for split size Lift, elevation, heel tapered to metatarsals, per inch Lift, elevation, heel and sole, neoprene, per inch Lift, elevation, heel and sole, cork, per inch Lift, elevation, inside shoe, tapered, up to one-half inch Heel wedge Clubfoot wedge Orthopedic shoe addition, convert instep to velcro closure EO, elastic with stays, pre, F&A Elbow orthosis, elastic, pre F&A, (e.g., neoprene, Lycra) 62
7 L3710 EO, elastic with metal joints, pre F&A L3720 EO, double upright with forearm/arm cuffs, free motion, custom L3730 EO, double upright with forearm/arm cuffs, extension/flexion assist, custom L3740 EO, double upright with forearm/arm cuffs, free motion, custom L3760 Elbow orthosis, with adjustable position locking joint(s), pre, F&A, any type L3762 Elbow orthosis, rigid, without joints, includes soft interface material, pre, F&A L3800 WHFO, short opponens, no attachments, custom L3805 WHFO, long opponens, no attachments, custom L3807 WHFO, without joints, pre, F&A, any type L3810 WHFO, addition to short and long opponens, thumb abduction ("C") bar L3890 Addition to upper extremity joint, wrist or elbw, concentric adjustable torsion style mechanism, each L3906 WHO, wrist gauntlet, molded to patient model, custom L3907 WHFO, wrist gauntlet with thumb spica, molded to patient model, custom L3908 WHO, wrist extension control cock-up, non-molded, pre, F&A L3909 Wrist orthosis, elastic, pre, F&A (e.g., neoprene, Lycra L3911 Wrist hand finger orthosis, elastic, pre, F&A (e.g., neoprene, Lycra) L3912 HFO, flexion glove with elastic finger control, pre, F&A L3914 WHO, wrist extension cock-up, pre, F&A L3923 HFO, without joints, pre, F&A L3936 WHFO, Palmer, pre, F&A L3938 WHFO, dorsal wrist, pre, F&A L3946 HFO, composite+f164 elastic, pre, F&A L3956 Addition of joint to upper extremity orthosis, any material; per joint L3999 Upper limb orthosis, NOS L4210 Repair of orthotic device, repair or replace minor parts L4392 Replacement soft interface material, static AFO Q4051 Splint supplies, miscellaneous (includes thermoplastics, strapping, fasteners, padding, and other supplies S5199 Adaptive, utensil, feeding S5199 Adaptive, cup, nosey S5199 Personal care item, NOS, each S8470 Stander, positioning device V5014 Hearing aid, repairs, over $100 V5014 Repair/modification of a hearing aid V5060 Hearing aid, monaural, behind the ear V5140 Hearing aid, binaural, behind the ear 63
8 V5150 V5160 V5241 V5267 V5264 V5266 V5266 V5267 V5267 V5267 V5336 Hearing aid, binaural, glasses Hearing aid dispensing fee, binaural Hearing aid dispensing fee, monaural Hearing aid, pediatric care kit Hearing aid ear mold/insert, not disposable, any type Battery for use in hearing aid Hearing aid, battery, silver, any size, each Hearing aid supplies/accessories Hearing aid, alligator clip Hearing aid, Replacement cord Repair/modification of augmentative communication system or device 64
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