L4360 Medicare Coverage Criteria

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L4360 Medicare Coverage Criteria

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Medicare Bulletin – May 2014 – CGS

May 5, 2014 … to Entities that Provide Coverage Complementary to …. which meet Medicare's
signature requirements. ….. L4361 and L4360 ….. CY 2015.


Medicare now differentiates between off-the-shelf and custom fitted type
prefabricated AFOs including … L4360, L4386 and L4396, new codes reflecting
the off-the-shelf definition most likely apply. Classification Algorithm – Overview
of Criteria. Determining Proper Coding of … http://downloads.cms.gov/medicare-

2014 Medicare Reimbursement Schedule – SureFit

2014 Medicare Reimbursement Schedule. Page 1 of 6. HCPCS … $88.26. L4360
Pneumatic walking boot prefab includes fitting & adjust. $287.67. $259.40.

J11 Part B Medicare Advisory – Palmetto GBA

Feb 17, 2014 … The J11 Part B Medicare Advisory contains coverage, billing and other …..
alternative means of satisfying the CR 8401 requirements until January 1, 2015.
…… Applicable FARS/DFARS apply. L4360. L4361 and L4360. L4386.

Orthotics Policy – Excellus BlueCross BlueShield

or local Medicare coverage decision for the specific service. … I. Based upon our
criteria and review of the peer-reviewed literature orthotic devices are considered
…. Copyright © 2015 American Medical Association, Chicago, IL. HCPCS: …
L4360. Walking boot, pneumatic and/or vacuum with or without joints, with or

February 2014 J11 HHH Medicare Advisory – Palmetto GBA

Feb 17, 2014 … The J11 HHH Medicare Advisory contains coverage, billing and other information
for Jurisdiction 11 HHH. This infor- mation is not … and obligations as mandated
by Medicare regulations and guidelines. ….. January 1, 2015.

2015 Spring Medicare Update

Mar 7, 2015 … Medicare Therapeutic Shoe documentation – now available on the APMA
website … the correct code for pneumatic CAM walker whereas L4360 … You can
bill Medicare to get a denial for orthotics that may be covered by a …

DME Web Based Workshop AFO and KAFO May 2015.pptx – Noridian

May 12, 2015 … All models, methodologies and guidelines are undergoing continuous …. May
2015. Noridian Jurisdiction D DME MAC. 18. Fitted. L4360.

January 2015 – Noridian

Jan 19, 2015 … All models, methodologies and guidelines are undergoing continuous
improvement and modification by Noridian and the Centers for Medicare &.
Medicaid …. 1/19/2015. 12. AFO/KAFO Custom Fitted Codes. L4360. L2035.

MassHealth Transmittal Letter ORT-24 February 2015 … – Mass.Gov

Jan 1, 2014 … The Centers for Medicare & Medicaid Services (CMS) has revised the Healthcare
… Prior-authorizations (PA) requirements, service limits, and …

SHBP Medical Policies & Clinical Guidelines … – BCBSGA

If you have any questions about which guidelines are applicable, please call the
… secondary coverage including those whose primary insurance carrier is
Medicare. ….. L4360. L4386. L4392-L4394. L4396. L4398. L4631. Updated: 2/24/
2015 …

Moda Health Plan, Inc. Medical Necessity Criteria Subject: Ankle …

Jun 24, 2015 … Origination Date: 05/2015. Revision … Criteria: CWQI: HCS-0121 (This criteria is
consistent with national and/or regional CMS guidelines for … AFO orthotics Not
covered by Medicare for ALL of the following: …. L4360. WALKING BOOT,

2015 CMS Changes; Written and Interpreted – Freedom Innovations

Apr 10, 2015 … 2015. O Proof of Delivery/Delivery Ticket. O What is actually meant by the …
Guidelines” …. O //www.medicarenhic.com/dme/whatsnew.aspx.

Orthotics 2014 new code update eff 1-1-14 – Capital Blue Cross

Dec 1, 2014 … Coverage for diabetic shoes is mandated by the requirements of Pennsylvania
Act 98 of. 1998 … by the Center for Medicare and Medicaid Services (CMS) and
documented in the …… L4360. PNEUMATI WALKING BOOT PREFAB. L4361.
WALKING BOOT, PNEUMATIC … ICD 10 Effective October 1, 2015:.

Quarter 2 – American Orthotic & Prosthetic Association

“Medicare Program; Requirements for Medicare Incentive Reward Program and
… implications for DoD, the VA, Medicare and health care more generally. …..
September 4-7. 2015. San Antonio (Convention Center). October 7 -10. 2016 ….
D has announced that the widespread pre-payment review for L4360, L1960,

2015 HCPCS Expert Level II Updates – OptumCoding

Dear 2015 HCPCS Level II Customer, … Medicare IVIG demonstration, Q2052
oxygen ….. pneumatic, L4360-L4361 ….. DSM IV criteria major depressive dis-.

Medical Necessity Guidelines: Orthoses, Lower … – Tufts Health Plan

2296247. 1. Medical Necessity Guidelines: Orthoses, Lower Extremity, Knee-
Ankle-Foot (KAFO) and Ankle-Foot (AFO). Medical Necessity Guidelines:
Orthoses, …

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