What is a L1906?

Long Description: ANKLE FOOT ORTHOSIS, MULTILIGAMENTOUS ANKLE SUPPORT, PREFABRICATED, OFF-THE-SHELF.

Does Medicare cover L1906?

Effective for claims with dates of service on or after April 1, 2012, the only products which may be billed to Medicare using code L1906 (ANKLE FOOT ORTHOSIS, MULTILIGAMENTUS ANKLE SUPPORT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT) are those for which a written coding verification has been made by the Pricing.

What is the purpose of an Arizona brace?

The Arizona Brace was designed for the treatment of posterior tibialis tendon dysfunction (PTTD). It is the only brace tested to be 90% effective at treating PTTD as an alternative to surgery. The brace fits into a comfort shoe and stabilizes the ankle area, the talocalcaneal, midtarsal and subtalar joints.

Will Medicare pay for ankle braces?

Yes, Medicare will help cover the costs of ankle braces. Beneficiaries pay only 20% of the cost for ankle braces with Part B. Benefits may include ankle braces, straps, guards, stays, stabilizers, and even heel cushions.

Does insurance cover AFO braces?

Ankle-foot orthoses (AFO) and knee-ankle foot orthoses (KAFO) are covered under the Medicare Braces Benefit.

How frequently can a patient get a new AFO by Medicare guidelines?

Coverage of a replacement interface is limited to a maximum of one (1) per 6 months. Additional interfaces will be denied as not reasonable and necessary. Medicare does not reimburse for a foot drop splint/recumbent positioning device (L4398) or replacement interface (L4394).

Can you run with an Arizona brace?

As a general rule, if the reason you are wearing the AFO is primarily an ankle instability issue, then in most cases you can run and be very active in the AFO just as many professional athletes wear knee braces during play.

Can you drive wearing an Arizona brace?

It is safe to wear while driving. We do suggest driving around the block first to make sure that you are used to the way the brace makes your foot and ankle feel while you are driving.

How often will Medicare pay for an ankle brace?

For example, Medicare and most insurance companies limit replacement ankle bracing to 1 brace every 5 years.

What is the requirements for an AFO?

AFO & KAFO Insurance Coverage Requirements

• The beneficiary has a weakness or deformity of the foot and ankle.
• The beneficiary requires stabilization of the foot and ankle for medical reasons.
• The beneficiary has the potential to benefit functionally from the use of an AFO.

Does Medicare pay for AFO braces?

Does insurance cover Afos?

Medicare will also cover AFO and KAFO prescriptions, although additional documentation and notes are necessary to receive full benefits. Documentation from the ordering physician, such as chart notes and medical records, is required for coverage.

How much does a Arizona brace cost?

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What shoes can you wear with Arizona braces?

Shoes

• A well-constructed lace up shoe will provide the best results.
• Shoes with removable insoles and/or added depth may be necessary to accommodate the AFO.
• Maintain a consistent heel height when switching between shoes.
• Notify your healthcare provider if you notice any irregular wear patterns on the soles of your shoes.

What does an Arizona brace cost?

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Do you sleep in walking boot?

You SHOULD keep the boot on while you’re laying around the house to prevent bumping the injury and to help the foot heal properly. Listening to your doctor and following the treatment plan will help to get you better and out of the boot faster!

What is l1906 ankle support?

L1906 ANKLE FOOT ORTHOSIS, MULTILIGAMENTOUS ANKLE SUPPORT, PREFABRICATED, INCLUDES FITTING AND ADJUSTMENT A multiligamentous ankle support provides control of the ankle joint between the medial and lateral malleoli while allowing for dorsiflexion and plantar flexion.

What is the l1906 code for multi ligamentous devices?

There are some multi ligamentous type devices that have been recommended to be billed using L1906 code such as the Ossur Exoform and the GameDay that do not have a foot plate. As such they would need to be billed as A9270.

What are the changes to l1906 on dmecs?

Products that are currently listed on DMECS with L1906 will be end dated effective March 31, 2012 and changed to A9270 until a coding verification review has been completed by the PDAC. Thus, it is mandatory that manufacturers submit to PDAC devices for L1906 verification in order for them to qualify for reimbursement.

Why do I need to verify my device for l1906 verification?

Thus, it is mandatory that manufacturers submit to PDAC devices for L1906 verification in order for them to qualify for reimbursement. There are some multi ligamentous type devices that have been recommended to be billed using L1906 code such as the Ossur Exoform and the GameDay that do not have a foot plate.