Insurance Information

Insurance Information

 

 

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Insurance Information

We do not bill any insurance.  The patient is responsible for getting a claim form from his/her insurance provider and submitting it to them for insurance reimbursement.  We strongly recommend that you contact your insurance company prior to ordering if you want to know whether you will be reimbursed for the item(s).

Most insurance companies will require a physician's prescription for the item, along with a diagnosis code, to avoid delay in processing the claim.  Some insurance providers may also require a Letter of Medical Necessity from a physician or therapist.

For Medicare claims, please be advised that we are not a Medicare supplier/provider; you will need to call the Medicare phone number on your Medicare card to see if the item(s) you are ordering are reimbursable.   

Insurance Codes

Below are insurance codes that will be included with your paid invoice, so that you may file an insurance claim for reimbursement after you receive your order.  We suggest you contact your insurance provider before ordering to see if the items are covered under your policy.

Delivery and handling fees, and casting/fitting charges most likely will not be reimbursed by insurance.  There are also some optional items (i.e., padded dorsal plate, additional finger lift, etc.) that may not be covered.

For custom orders we will send you an estimate once we receive all of your paperwork.  The estimate will have the insurance codes on it, as well as itemized charges.

 

CUSTOM ORTHOTICS

Item

Medicare Codes

 Hand Paddle

 L3913

Dome Positioning Splint

L3906

Clear Natural Resting Position Splint

L3906

 Interchangeable Dome Positioning Hand Piece for WHO or EWHO

 L3913

PRO Prep L1990
L1940
L2220x2
PRO Insole™ L3000
L3001

Perfect Response Orthotic® (PRO)

L1970
L2280
L2755
L2820
L2275
L2220x2

PRO KAFO

L1970
L2280
L2755
L2820
L2275
L2220x2
L2020
L2540
L2760x2

Wrist-Hand-Orthosis (WHO)

 -w/ option 1 ratchet Joint or option 2 step lock joint

 

 

 L3905

 L2430

Wrist-Hand-Orthosis (WHO)

 -w/ option 3 adjustable static joint

 

 

 L3905

 L2425

Transitional PRO

 L3000

 L3001

 L4350

 Elbow-Wrist-Hand- Orthosis  (EWHO)

-w/ option 1 ratchet joints or option 2 step lock joints

 L3906

 L2820

 L3730

 L2430x2

 Elbow-Wrist-Hand- Orthosis  (EWHO)

-w/ option 3 adjustable static joints

 L3906

 L2820

 L3730

 L2425x2

 

PREFABRICATED ORTHOTICS AND THERAPY AIDS

Item

Medicare Codes

Prefabricated Hand Paddle

 L3923

Prefabricated Flat Paddle w/ Straps L3923

 Prefabricated Humeral External Rotator

 L3962

Hand Positioning Accessories Type 1,2,3,5,6 L3913
Hand Positioning Accessories Type 4 L3908
Hand Positioning Accessories Type 8 L3931

Prefabricated Knee Immobilizer

 L1836

           Prefabricated Knee Anti-hyperextension Unit
 Type 1

 

 L1850

           Prefabricated Knee Anti-hyperextension Unit
 Type 2
L1820

 Prefabricated Hip Alignment Assist Unit for Function in Upright Postures
 

 L1686

 Prefabricated Dome Positioning Splint

L3931


Prefabricated Articulating Dome Positioning Splint
L3931
L2430

 Interchangeable Dome Positioning Hand Piece for WHO or EWHO

 L3913

Prefabricated Dorsiflexion Stretch Assist L1971

Prefabricated Thoracic Extension Unit

L0472

Prefabricated Dorsiflexion Stretch Assist

L1971

Light and Ultra Light Bivalve Elbow Support L3762

 Light Prefabricated Wrist-Hand-Orthosis (WHO)

 L3931

 Prefabricated Wrist-Hand-Orthosis (WHO)

-w/ option 1 ratchet joint or option 2 step lock joint

 L3931

L2430

 Prefabricated Wrist-Hand-Orthosis (WHO)

-w/ option 3 adjustable static joint

 L3931

L2425

 Prefabricated Elbow-Wrist-Hand-Orthosis  (EWHO)

-w/ option 1 ratchet joints or option 2 step lock joints

 L3760

 L3931

L2430x2

 Prefabricated Elbow-Wrist-Hand-Orthosis  (EWHO)

-w/ option 3 adjustable static joints

 L3760

 L3931

L2425x2