Field Name |
Field Value |
Healthcare Common Procedure Coding System Code |
A5513 |
HCPCS Sequence Number |
0010 |
HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
HCPCS Long Description |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer or higher), includes arch filler and other shaping material, custom fabricated, each |
HCPCS Short Description |
Multi den insert custom mold |
HCPCS Pricing Indicator Code 1 |
38 - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) |
HCPCS Multiple Pricing Indicator Code |
A - Not applicable as HCPCS priced under one methodology |
HCPCS Coverage Code |
C - Carrier judgment |
HCPCS Berenson-Eggers Type Of Service Code |
D1F - Prosthetic/Orthotic devices |
HCPCS Type Of Service Code 1 |
J - Diabetic shoes (eff 04/95) |
HCPCS Anesthesia Base Unit Quantity |
0 |
HCPCS Code Added Date |
1/1/2006 |
HCPCS Action Effective Date |
1/1/2010 |
HCPCS Action Code |
N - No maintenance for this code |