L1920-Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated, conventional
The following add-on codes may be used for this base code (only code for what you use):
L2360-Extended Steel Shank x 1ea
L2370-Patten Bottom x 1ea
L2750- Plating Material x 1ea
L2755-Carbon graphite construction x 1ea
L2760-Growth Extension x 1ea
L2768-Side Bar, Disconnect x1 per bar
L2780-Non-Corrosive Finish x 1 per bar
L2999-Not otherwise specified
L1950-Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated
The following add-on codes may be used for this base code (only code for what you use):
L2275-Varus/Valgus plastic modification x 1ea
L2755-Carbon graphite construction x 1ea
L2820-BK soft interface, mold plast x 1ea
L2840-Tibial length sock, Fx or = x 2ea
L2999-Not otherwise specified
L1960-Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated
The following add-on codes may be used for this base code (only code for what you use):
L2232-Rocker bottom x 1ea
L2270-Varus/Valgus corrective T-strap, padded/lined x 1ea
L2275-Varus/Valgus plastic modification x 1ea
L2280-Molded inner boot x 1ea
L2340-Pre-Tibial shell, molded to Pt. x 1ea
L2350-Pros BK, PTB-AFO type Brim, molded to Pt. x 1ea
L2755-Carbon graphite construction x 1ea
L2820-BK soft interface, mold plast x 1ea
L2840-Tibial length sock, Fx or = x 2ea
L2999-Not otherwise specified
L1970-Ankle foot orthosis, plastic with ankle joint, custom fabricated
The following add-on codes may be used for this base code (only code for what you use):
L2200-Limited Ankle Motion, each joint
L2210-Dorsi Assist/Plant Flex Resist, each joint
L2220-Dorsi/Plant Flex Assist/Resist, each joint
L2270-Varus/Valgus corrective T-strap, padded/lined x 1ea
L2275-Varus/Valgus plastic modification x 1ea
L2280-Molded inner boot x 1ea
L2340-Pre-Tibial shell, molded to Pt. x 1ea
L2350-Pros BK, PTB-AFO type Brim, molded to Pt. x 1ea
L2755-Carbon graphite construction x 1ea
L2820-BK soft interface, mold plast x 1ea
L2840-Tibial length sock, Fx or = x 2ea
L2999-Not otherwise specified
L1980-Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar 'bk' orthosis), custom fabricated
The following add-on codes may be used for this base code (only code for what you use):
L2280-Molded inner boot x 1ea
L2320-Non-molded lacer x1ea
L2330-Lacer Molded to patient model x1ea
L2340-Pre-Tibial shell, molded to Pt. x 1ea
L2350-Pros BK, PTB-AFO type Brim, molded to Pt. x 1ea
L2360- Extended steel shank x1ea
L2370-Patten bottom
L2750-Platting material
L2755-Carbon graphite construction x 1ea
L2760- Growth extension x per bar
L2768- Side bar, disconnect x per bar
L2780-Non corrosive finish x per bar
L2820-BK soft interface, mold plast x 1ea
2861- Concentric adjustable torsion
L3224- Woman’s oxford shoe, attached to AFO
L3225-Man’s oxford shoe, attached to AFO
L2200-Limited Ankle Motion, each joint
L2210-Dorsi Assist/Plant Flex Resist, each joint
L2220-Dorsi/Plant Flex Assist/Resist, each joint
L2230-Split Flat Caliper Stirrups and Plate x1ea
L2240-Round caliper and plate x1ea
L2250-Footplate, stirrup attachment, mold to
L2260-Reinforce solid stirrup x1ea
L2265-Long tongue stirrup x1ea
L2270-Varus/Valgus corrective T-strap, padded/lined x 1ea