| HCPCS Code: |
L4210 |
| Long Description: |
Repair of orthotic device, repair or replace minor parts |
| Short Description: |
Orth dev repair/repl minor p |
| Pricing Indicator 1: |
46 (Carrier priced (e.g., not otherwise classified, individual determination, carrier discretion, gap-filled amounts)) |
| Multiple Pricing Code: |
A (Not applicable as HCPCS priced under one methodology) |
| MCM Reference Section Number 1: |
2133 |
| MCM Reference Section Number 2: |
2100.4 |
| MCM Reference Section Number 3: |
2130D |
| 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: |
P (Lump sum purchase of DME, prosthetics, orthotics) |
| Anesthesia Base Unit Quality: |
0 |
| Code Added: |
01-01-1985 |
| Action Effective Date: |
01-01-1996 |
| Action Code: |
N (No maintenance for this code) |
