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L4205 - Ortho dvc repair per 15 min

Navigation: HCPCS Codes > Codes with Prefix: L4
Field Value
HCPCS Code: L4205
Long Description: Repair of orthotic device, labor component, per 15 minutes
Short Description: Ortho dvc repair per 15 min
Pricing Indicator 1: 46 (Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
MCM Reference Section Number 1: 2100.4
Statute Number:
Coverage Code: D (Special coverage instructions apply)
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: 01-01-1997
Action Effective Date: 01-01-1997
Action Code: N (No maintenance for this code)