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L1906 ankle brace letter of medical necessity documentaion 2025

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The document is a Certificate of Medical Necessity for a Thermoskin Ankle Foot Orthosis (AFO) detailing patient information, insurance details, and indications for use. It outlines specific medical conditions justifying the need for the orthosis, including ankle pain and joint disorders. The physician certifies that the AFO is necessary for the patient's treatment plan related to diabetes, foot pain, or arthritis.

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What is medical code L1906?

L1906 (ANKLE FOOT ORTHOSIS, MULTILIGAMENTOUS, ANKLE SUPPORT, PREFABRICATED, OFF-THE-SHELF) describes a prefabricated AFO which provides multi-directional support to the ankle ligaments while allowing free dorsiflexion and plantarflexion motion.

What is the medical justification for AFO?

Medical records document the basic coverage criteria: Beneficiary is ambulatory; and Has a weakness or deformity of the foot and ankle; and Requires stabilization of the foot and ankle for medical reasons; and Has the potential to benefit functionally from the use of an AFO.

Is an ankle brace a DME?

Orthopedic DMEs are typically braces and supports for the arms, ankles, elbows, back and more. These orthotic devices are ideal for physical therapy, rehabilitation and preventative support.

Does Medicare pay for an ankle brace?

Medicare does provide coverage for ankle braces, extending its benefits to a range of supportive devices. This includes not just the ankle braces themselves, but also additional components like straps, guards, stays, stabilizers, and even heel cushions.

Are braces considered DME?

DME (such as hospital beds, wheelchairs, ventilators, and oxygen equipment) Prosthetics and Orthotics (artificial legs, arms, and eyes, and leg, arm, back and neck braces)

cpt l4361 medicare guidelines

L1906 CPT code description L4397 CPT code description Ankle brace cpt code L2820 CPT code description L1902 Medicare reimbursement L2820 brace L4361 Medicare reimbursement L1970 CPT code description

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What is the medical term for ankle brace?

Ankle-foot orthoses (AFOs) are among the most commonly prescribed lower limb orthoses. They are custom made for each individual to encompass the foot, ankle and leg, finishing just below the knee.

Is a leg brace durable medical equipment?

Yes. Medicare Part B provides coverage for whats known as Durable Medical Equipment (DME). The coverage includes arm, leg, neck, and back braces, but there are specific stipulations.

L1906 ankle brace letter of medical necessity documentaion 2025

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