What diagnosis codes can be used for CPT code L2114 (camwalker boot)?
HCPCS L2114: Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment
Reference: https://www.cms.gov/medicare/coding-billing/healthcare-common-procedure-system
This is not the code that represents what most podiatrists consider a "CAM Walker."
Medicare provides guidance regarding ankle-foot-orthosis (AFO) coverage through its DME MACs and their coverage policy for L2114 is here: https://www.cms.gov/medicare-coverage-database/view/lcd.aspx?lcdid=33686&ver=30&ContrId=140&ContrVer=2&CntrctrSelected=140*2&Cntrctr=140&name=&DocType=2&bc=AAACAAYAAAAA&=
By these guidelines, L2114 represents an AFO that is a fracture orthosis used to address a tibial fracture. It must be used for ambulatory beneficiaries who have weakness or deformity of the foot and ankle, require stabilization for medical reasons, and have the potential to benefit functionally. Furthermore, "includes fitting and adjustment" in the code descriptor means custom fitting is required for use of the code, which means the medical necessity of, performance of, and documentation of "more than minimal self-adjustment by a qualified practitioner" at the time of dispensing is required.
Current Procedural Terminology (CPT®) is copyright 1966, 1970, 1973, 1977, 1981, 1983-2023 by the American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association (AMA).
Jeffrey D. Lehrman, DPM, FASPS, MAPWCA, CPC, CPMA
Certified Professional Coder
Certified Professional Medical Auditor
Lehrman Consulting, LLC