Sadmerc Letter Question

[Questions]

Question:

I was just wondering if you knew whether or not the Moore Balance Brace has a SADMERC letter?
Thank you,

Answer:

http://www.cms.gov/medicare-coverage...=IAAAABAAAAAA&

Above is link to recent Local Coverage Article from Medicare on coding of Arizona-type AFOs

According to the description:

For the Arizona Short, Arizona Tall, Arizona Extended, Arizona Unweighting, and similar custom fabricated braces, only the following codes should be used:


L1940 Ankle foot orthosis, plastic or other material, custom fabricated
L2330 Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only
L2820 Addition to lower extremity orthosis, soft interface for molded plastic below knee section

L2330 is used whether the closure is a lacer closure or a velcro closure. L2820 is used only if a soft interface, either leather or other material, is provided.

PDAC letter not required for custom afos though AZ is in processing of submitting.