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Coding redetermination for custom diabetic inserts announced

14:59 EDT 11 Aug 2017 | Healio

A publication released in July by the Medicare administrative contractor for durable medical equipment, which clarified the use of billing code A5513 for custom diabetic inserts, has spurred a coding redetermination that will end all previous A5513 verifications by the end of May 2018, according to a press release from the American Orthotic and Prosthetic Association (AOPA).The Medicare administrative contractor for durable medical equipment issued a publication stating that in order to meet the descriptor requirements of Healthcare Common Procedure Coding System (HCPCS) code A5513, custom diabetic inserts must be molded over an actual model of the patient’s foot. The use of electronic, or “virtual” models, without a physical model, does not meet this requirement, the publication reported.

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