L3070 |
 |
Foot, arch support, non-removable attached to shoe, longitudinal, each
short | Arch suprt att to sho longit |
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
L3080 |
 |
Foot, arch support, non-removable attached to shoe, metatarsal, each
short | Arch supp att to shoe metata |
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
L3090 |
 |
Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each
short | Arch supp att to shoe long/m |
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
L3100 |
 |
Hallus-valgus night dynamic splint, prefabricated, off-the-shelf
short | Hallus-valgus nt dyn pre ots |
MUE | Location | Value | Ajudication Indicator | Rationale |
---|
PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | DME | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
|
|
|