Browse HCPCS Level II 2020 Edition

L3340 - L3420  Shoe Modification - Shoe Wedges

L3340 Heel wedge, sach short Shoe wedge sach 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

L3350 Heel wedge short Shoe heel wedge 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

L3360 Sole wedge, outside sole short Shoe sole wedge outside sole 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

L3370 Sole wedge, between sole short Shoe sole wedge between sole 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

L3380 Clubfoot wedge short Shoe clubfoot wedge 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

L3390 Outflare wedge short Shoe outflare wedge 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

L3400 Metatarsal bar wedge, rocker short Shoe metatarsal bar wedge ro 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

L3410 Metatarsal bar wedge, between sole short Shoe metatarsal bar between 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

L3420 Full sole and heel wedge, between sole short Full sole/heel wedge btween 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