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L4631 - Afo, walk boot type, cus fab

Navigation: HCPCS Codes > Codes with Prefix: L4
Field Value
HCPCS Code: L4631
Long Description: Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated
Short Description: Afo, walk boot type, cus fab
Pricing Indicator 1: 38 (Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
Statute Number:
Coverage Code: C (Carrier judgment)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: D1F (Orthotic devices)
Type of Service Code 1: P (Lump sum purchase of DME, prosthetics, orthotics)
Anesthesia Base Unit Quality: 0
Code Added: 01-01-2011
Action Effective Date: 01-01-2011
Action Code: N (No maintenance for this code)