DME Services, Ortho and Rehab Products

Medicare Diagnostic Criteria
Foot and Ankle†
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Ankle-Foot Orthoses and Knee-Ankle-Foot Orthoses
Used During Ambulation

Ankle-foot orthoses described by codes L1900, L1902-L1990, L2106-L2116, L4350, L4360, and L4386 are covered for ambulatory patients with weakness or deformity of the foot and ankle, which require stabilization for medical reasons, and have the potential to benefit functionally. Dictated notes must include the criteria listed below:

1. Describe any weakness or deformity of the patientís foot and/or ankle.

2. Describe why this patient requires the orthoses for stabilization.

3. Describe the potential functional benefit of the orthoses prescribed for this patient.


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