2024 HCPCS Code K0903

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

TAGS: rectified density custom minimum total diabetics durometer technology carving shaping multiple digitized layer model filler created contact direct shore material

Notice	HCPCS K0903 terminated on December 31, 2018.
Short Description	Mult den insert dir carv/cam
HCPCS Coverage Code	C - Carrier judgment
HCPCS Action Code	N - No maintenance for this code
HCPCS Action Effective Date	January 01, 2019
HCPCS Code Added Date	April 01, 2018
HCPCS Pricing Indicator Code	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 Issues Manual Reference Section Number
HCPCS Type Of Service Code	J - Diabetic shoes (eff 04/95)
HCPCS Anesthesia Base Unit Quantity	0

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