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For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe

HCPCS code

Medical Policies and Guidelines for For diabetics only, direct formed, compression molded to patient's foot without external heat source, multiple-density insert(s) prefabricated, per shoe

Related policies from health plans

Therapeutic Shoes, Inserts or Modifications for Individuals with Diabetes
CG-DME-19 Therapeutic Shoes, Inserts or Modifications for Individuals with Diabetes
Orthotic Devices and Shoes - (0543)
Orthotics - Medicare Advantage

Similar Codes


ICD10CM codes

S90.821 - Blister (nonthermal), right foot
E11.621 - Type 2 diabetes mellitus with foot ulcer
E10.621 - Type 1 diabetes mellitus with foot ulcer
E09.621 - Drug or chemical induced diabetes mellitus with foot ulcer
E13.621 - Other specified diabetes mellitus with foot ulcer
S90.829 - Blister (nonthermal), unspecified foot
E08.621 - Diabetes mellitus due to underlying condition with foot ulcer
Z86.31 - Personal history of diabetic foot ulcer
S90.82 - Blister (nonthermal) of foot
S90.821A - Blister (nonthermal), right foot, initial encounter

HCPCS codes

A5510 - For diabetics only, direct formed, compression molded to patient's foot without external heat source
A5512 - For diabetics only, multiple density insert, direct formed, molded to foot after external heat sourc
A5500 - For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf de
A5501 - For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from
A5508 - For diabetics only, deluxe feature of off-the-shelf depth-inlay shoe or custom-molded shoe, per shoe
A5506 - 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-
A5513 - For diabetics only, multiple density insert, custom molded from model of patient's foot, total conta
A5504 - For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-mol
A5505 - For diabetics only, modification (including fitting) of off-the-shelf depth-inlay shoe or custom-mol

CPT4 codes

29581 - Application of multi-layer compression system; leg (below knee), including ankle and foot
29582 - Application of multi-layer compression system; thigh and leg, including ankle and foot, when perform
28810 - Amputation, metatarsal, with toe, single
28805 - Amputation, foot; transmetatarsal
28003 - Incision and drainage below fascia, with or without tendon sheath involvement, foot; multiple areas
28260 - Capsulotomy, midfoot; medial release only (separate procedure)
4305F - Patient education regarding appropriate foot care and daily inspection of the feet received (CWC)
97762 - Checkout for orthotic/prosthetic use, established patient, each 15 minutes
29550 - Strapping; toes
29540 - Strapping; ankle and/or foot