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L3207 Service Type Codes to Send

HCPCS code

Orthotics (braces and supports)

CMS description

Orthopedic shoe, hightop with supinator or pronator, junior

Why these codes

5010 has no orthotics code; payers answer braces under DME, some under prosthetic devices.

If a payer returns nothing

Payers don't all answer every service type. Send 30 (Health Benefit Plan Coverage) for the plan's general benefits.

Sources

CMS HCPCS Level II descriptor; X12 HIPAA 5010 service type code definitions; VerifyTX billing practice

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