| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
550 |
451 |
$35K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
236 |
205 |
$34K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
222 |
200 |
$28K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
557 |
458 |
$16K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
42 |
41 |
$8K |
| E0731 |
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) |
27 |
27 |
$6K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
19 |
14 |
$879.55 |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
18 |
14 |
$810.20 |