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HCPCS
K0903

HCPCS Code K0903
Deleted

Official Description

For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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
Short Descr Mult den insert dir carv/cam
Coverage Carrier Priced
Pricing Indicator(s) 38 – Supplies And Surgical Dressings - Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings)
MPI A – Not applicable, as HCPCS priced under one methodology
BETOS D1F – Prosthetic/Orthotic devices
TOS Code(s) J – Diabetic shoes
Added Date 4/1/2018
Termination Date 12/31/2018
APC Status Indicator Non-Implantable Durable Medical Equipment
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2018-12-31 Deleted Deleted
2018-04-01 Added Code added.
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