For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe
Basic Information
| Added: | 1/1/1995 |
| HCPCS Action Effective Date | 1/1/2005 |
| HCPCS Action Code/Description | N / No maintenance for this code |
| Short Description: | Diabetic shoe with wedge |
| Long Description: | For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-molded shoe with wedge(s), per shoe |
| Anesthesia Base Unit Quantity | 0 |
Service Code Information
| HCPCS Berenson-Eggers Type Of Service Code/Description: | D1F / Prosthetic/Orthotic devices |
| HCPCS Type Of Service Code #1 | J |
| Type Of Service Cod #1 Description | Diabetic shoes (eff 04/95) |
Pricing/Coverage Information
| Coverage Code | D |
| Description | Special coverage instructions apply |
| Pricing Indicator Code #1 | 38 |
| Pricing Indicator Code #1 Description | Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
| Pricing Indicator Code #1 Type | Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings |
| Multi-Pricing Indicator Code | A |
| Description | Not applicable as HCPCS priced under one methodology |
| Medicare Carriers Manual Reference Section #1 | 2134 |
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