| HCPCS Code: |
A5501 |
| Long Description: |
For diabetics only, fitting (including follow-up), custom preparation and supply of shoe molded from cast(s) of patient's foot (custom molded shoe), per shoe |
| Short Description: |
Diabetic custom molded shoe |
| Pricing Indicator 1: |
38 (Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| MCM Reference Section Number 1: |
2134 |
| Statute Number: |
|
| Coverage Code: |
D (Special coverage instructions apply) |
| ASC Payment Group Code: |
|
| Processing Note Number: |
|
| Berenson-Eggers Type of Service (BETOS) Code: |
D1F (Orthotic devices) |
| Type of Service Code 1: |
J (Diabetic shoes (effective 04/95)) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1995 |
| Action Effective Date: |
01-01-2005 |
| Action Code: |
N (No maintenance for this code) |
