The four Durable Medical Equipment Medicare Administrative Contractors (DME MACs) have provided a joint publication with the correct coding to use for the Intrepid Dynamic Exoskeletal Orthosis (IDEO) and ExoSym energy storing AFO. Based upon a review of the published clinical literature and publically available descriptive information, the correct combination of Healthcare Common Procedure Coding System (HCPCS) codes for billing the IDEO, the ExoSym and similar braces follows.
- L-1945: AFO, plastic, rigid anterior tibial section (floor reaction), custom fabricated
- L-2755: addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only
Only codes L-1945 and L-2755, in combination, may be used to bill for this type of brace. Use of the Not Otherwise Classified (NOC) code L-2999 is incorrect.
