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For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe

HCPCS code

Medical Policies and Guidelines for For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe

Related policies from health plans

Orthotics
Orthotics
Orthotics - Medicare Advantage

Similar Codes


ICD10CM codes

Z46.81 - Encounter for fitting and adjustment of insulin pump
E11.621 - Type 2 diabetes mellitus with foot ulcer
E09.621 - Drug or chemical induced diabetes mellitus with foot ulcer
E10.621 - Type 1 diabetes mellitus with foot ulcer
E13.621 - Other specified diabetes mellitus with foot ulcer
E08.621 - Diabetes mellitus due to underlying condition with foot ulcer
Z13.1 - Encounter for screening for diabetes mellitus
Z86.31 - Personal history of diabetic foot ulcer
Z44.8 - Encounter for fitting and adjustment of other external prosthetic devices
E11.618 - Type 2 diabetes mellitus with other diabetic arthropathy

HCPCS codes

A5500 - For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf de
A5506 - For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-mol
A5508 - For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
A5504 - For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-mol
A5507 - For diabetics only, not otherwise specified modification (including fitting) of off-the-shelf depth-
A5501 - For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from
A5505 - For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-mol
A5503 - For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-mol
A5510 - For diabetics only, direct formed, compression molded to patient's foot without external heat source
A5513 - For diabetics only, multiple density insert, custom molded from model of patient's foot, total conta

CPT4 codes

3754F - Screening tests for diabetes mellitus reviewed, requested, or ordered (DSP)
28003 - Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas
20702 - Manual preparation and insertion of drug-delivery device(s), intramedullary (List separately in addi
83525 - Insulin; total
95250 - Ambulatory continuous glucose monitoring of interstitial tissue fluid via a subcutaneous sensor for
20700 - Manual preparation and insertion of drug-delivery device(s), deep (eg, subfascial) (List separately
21084 - Impression and custom preparation; speech aid prosthesis
29582 - Application of multi-layer compression system; thigh and leg, including ankle and foot, when perform
4305F - Patient education regarding appropriate foot care and daily inspection of the feet received (CWC)
29581 - Application of multi-layer compression system; leg (below knee), including ankle and foot