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SECCIÓN QUINTA. OTRAS CONDICIONES

In the earlier part of the 20th century, pediatric orthopedic shoes were widely prescribed by pediatricians to help children’s feet. The widespread belief was that using special shoes as orthotic therapy would allow the young bones to grow the proper way.

As the century progressed, the widespread use of such shoes waned as research indicated that many conditions were normally outgrown as a part of normal development. In addition, advances in therapy using custom orthoses have allowed combinations of regular shoes and custom orthoses to provide correction that used to be achieved with these “corrective shoes.” Pediatric orthopedic shoes are now reserved for the more severe cases where doctors do not believe the child will normally outgrow the condition without orthotic assistance. This is often associated with rotational issues.

The main codes currently in existence are:

L3140 FOOT, ABDUCTION ROTATION BAR, INCLUDING SHOES L3150 FOOT, ABDUCTION ROTATATION BAR, WITHOUT SHOES L3160 FOOT, ADJUSTABLE SHOE-STYLED POSITIONING DEVICE

L3201 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, INFANT L3202 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, CHILD L3203 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, JUNIOR L3204 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, INFANT L3206 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, CHILD L3207 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, JUNIOR L3208 SURGICAL BOOT, EACH, INFANT

L3209 SURGICAL BOOT, EACH, CHILD L3211 SURGICAL BOOT, EACH, JUNIOR L3212 BENESCH BOOT, PAIR, INFANT L3213 BENESCH BOOT, PAIR, CHILD L3214 BENESCH BOOT, PAIR, JUNIOR

L3640 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, DENNIS BROWNE SPLINT (RIVETON), BOTH SHOES

These code descriptions are not ME-CE—and have caused much confusion. In addition, there are certain codes that are outdated and need to be retired.

For the purpose of the following codes, each of the three distinct sizes, Infant, Child and Junior will be defined as follows:

Infant = Anything up to Children’s Size 8

Child = Children’s Size 8.5 through Children’s Size 12 Junior = Children’s Size 12.5 through Children’s Size 6

PCC/New Description Explanation

Discontinue use We recommend the discontinuation of this code because the practitioner should use L3150 plus the correct shoe code. Old Description

L3150 Pediatric rotational device, attached to shoes, each device.

This is a device either permanently or temporarily attached to shoes for the pur- pose of correcting a rotational deficiency. L3160 FOOT, ADJUSTABLE

SHOE-STYLED POSITIONING DEVICE

L3201 Pediatric OTS Shoe, unisex, low top with adjustable closure, with supination or pronation correction, Infant size, each foot.

This code is for any Pediatric OTS low top shoe with an adjustable closure and supi- nation or pronation correction. Child sizes. L3140 FOOT, ABDUCTION

ROTATION BAR, INCLUDING SHOES

L3150 FOOT, ABDUCTION ROTATATION BAR, WITHOUT SHOES

L3160 FOOT, ADJUSTABLE SHOE-STYLED POSITIONING DEVICE

This code is for any Pediatric OTS low top shoe with an adjustable closure and supina- tion or pronation correction. Infant sizes. L3201 ORTHOPEDIC SHOE,

OXFORD WITH SUPINATOR OR PRONATOR, INFANT

L3202 Pediatric OTS Shoe, unisex, low top with adjustable closure, with supination or pronation correction, Child size, each foot.

L3202 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, CHILD

A Pediatric two-piece shoe where the forefoot and hindfoot can be positioned independently for forefoot adduction or abduction. The two pieces have separate closures for control.

This code is for any Pediatric OTS low top shoe with an adjustable closure and supi- nation or pronation correction. Junior sizes. L3203 Pediatric OTS Shoe,

unisex, low top with adjustable closure, with supination or pronation correction, Junior size, each foot.

L3203 ORTHOPEDIC SHOE, OXFORD WITH SUPINATOR OR PRONATOR, JUNIOR

This code is for any Pediatric OTS high top shoe with an adjustable closure and supina- tion or pronation correction. Infant sizes. L3204 Pediatric OTS Shoe,

unisex, high top with adjustable closure, with supination or pronation correction, Infant size, each foot.

L3204 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, INFANT

This code is for any Pediatric OTS high top shoe with an adjustable closure and supina- tion or pronation correction. Child sizes. L3206 Pediatric OTS Shoe,

unisex, high top with adjustable closure, with supination or pronation correction, Child size, each foot.

L3206 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, CHILD

PCC/New Description Explanation L3207 Pediatric OTS Shoe,

unisex, high top with adjustable closure, with supination or pronation correction, Junior size, each foot.

This code is for any Pediatric OTS high top shoe with an adjustable closure and supina- tion or pronation correction. Junior sizes. Old Description

L3208 Pediatric Surgical Boot, closed toe, unisex, high top with surgical closure, Infant size, each foot.

This code is for any Pediatric OTS boot with a surgical closure where the vamp opens all of the way to the toe of the shoe for easier donning and doffing. Infant sizes.

L3209 Pediatric Surgical Boot, closed toe, unisex, high top with surgical closure, Child size, each foot.

L3211 Pediatric Surgical Boot, closed toe, unisex, high top with surgical closure, Junior size, each foot.

The PCC believes that this device is no longer available nor used.

L3207 ORTHOPEDIC SHOE, HIGHTOP WITH SUPINATOR OR PRONATOR, JUNIOR

L3208 SURGICAL BOOT, EACH, INFANT

L3209 SURGICAL BOOT, EACH, CHILD

This code is for any Pediatric OTS boot with a surgical closure where the vamp opens all of the way to the toe of the shoe for easier donning and doffing. Junior sizes.

L3211 SURGICAL BOOT, EACH, JUNIOR

Discontinue L3212 BENESCH BOOT,

PAIR, INFANT

This code is for any Pediatric OTS boot with a surgical closure where the vamp opens all of the way to the toe of the shoe for easier donning and doffing. Child sizes.

The PCC believes that this device is no longer available nor used.

Discontinue L3213 BENESCH BOOT,

PAIR, CHILD

The PCC believes that this device is no longer available nor used.

Discontinue L3214 BENESCH BOOT,

PAIR, JUNIOR

This code is for the labor component of removing, transferring and reattaching the splint to a new pair of shoes, using rivets. L3640 Transfer of an orthoses

from one shoe to another, Denis Browne splint, riveted-on, both shoes.

L3640 TRANSFER OF AN ORTHOSIS FROM ONE SHOE TO ANOTHER, DENNIS BROWNE SPLINT (RIVETON), BOTH SHOES

FAQ:

Q: If I attach a Denis Browne bar using a thumb screw attachment system, may I bill the L3640 code as my labor component?

CHAPTER BH: CUSTOM AND OTS FOOT ORTHOSES