Custom-Fit Adjustable Ankle Foot Orthosis (AFO) HCPCS Code L4396

To bill for Custom-Fit Adjustable Ankle Foot Orthoses (AFOs), healthcare professionals must use HCPCS Level II codes, which categorize medical products and services outside the CPT system. All bracing and orthopedic devices are classified under the "L" series of HCPCS codes to ensure accurate reimbursement and compliance.

HCPCS Code:

L4396

Definition:

Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

This code applies to Custom-Fit Adjustable AFOs, featuring adjustable components for positioning and minimal ambulation support. These braces are trimmed, bent, molded, or assembled by healthcare providers to ensure a precise fit. Designed for contracture prevention, joint positioning therapy, and post-surgical immobilization, these PDAC Approved, Medicare-compliant AFOs provide effective stabilization and rehabilitation benefits.

Clinical Use Cases for L4396 Custom-Fit Ankle Foot Orthoses (AFOs)

Contracture Prevention and Management

Maintains proper foot and ankle positioning to prevent muscle contractures and deformities in patients with neurological or orthopedic conditions.

Post-Surgical Immobilization

Provides secure positioning and controlled support to aid in healing following foot or ankle surgeries.

Limited Ambulation Support

Assists patients with restricted mobility, offering gentle stabilization and protection for safe weight-bearing activities.

Why Healthcare Providers Choose Brace Direct

Comprehensive Product Selection

Our extensive range of PDAC-approved braces ensures you'll find the perfect solution for every patient's unique needs. From off-the-shelf options to specialized supports, we provide high-quality products that meet stringent medical standards.
Streamlined Ordering Process

Our user-friendly online platform allows for quick and efficient product selection. Search by specific codes, patient conditions, or product features to find exactly what you need with minimal effort.
Expert Clinical Support

Access a wealth of educational resources including detailed fitting guides, instructional videos, and direct support from our team of bracing specialists. We're committed to supporting healthcare providers in delivering optimal patient care.

Cost-Effective Solutions

Benefit from competitive pricing, volume discounts, and our Provider Discount Program. We help you manage costs without compromising on the quality of patient care and support.

Provider Discount Program

Save on wholesale orders and access exclusive volume discounts for your practice. Our program makes it easy to stock high-quality, PDAC-approved braces at competitive prices, ensuring your patients receive the best care while keeping your costs low.

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Become an Affiliate

Earn commissions by referring patients to trusted, high-quality braces. Our Affiliate Program offers a seamless way to recommend PDAC-approved products to your patients while creating an additional revenue stream for your practice.

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Explore Our L4396 PDAC Approved Custom-Fit Ankle Foot Orthoses

Provide your patients with precisely fitted stabilization and positioning support using our PDAC Approved Custom-Fit AFOs. Designed for healthcare professionals, these Medicare-compliant braces ensure optimal patient care and rehabilitation.

View Custom-Fit AFO Collection

Frequently Asked Questions

How can I ensure correct billing for DME (Durable Medical Equipment)? + –

To bill for DME, you’ll need proper documentation, including patient diagnosis, medical necessity, and a detailed prescription. Be sure to use the appropriate modifiers (e.g., KX, RT, LT) and maintain compliance with Medicare guidelines.

Why doesn't Brace Direct work with insurance or Medicare? + –

Brace Direct follows a direct-to-consumer model to offer affordable prices, upfront pricing transparency, and faster access to braces without the delays and complexities of insurance or Medicare billing. Many products are FSA and HSA eligible for added convenience.
Direct-to-Consumer Medical Braces & Supports: No Insurance Hassles

How does Brace Direct support healthcare providers? + –

We offer an extensive range of PDAC-approved products, educational resources, and a user-friendly ordering platform. Additionally, our Provider Discount Program helps practices manage costs while delivering high-quality care.

What does PDAC approval mean, and why is it important? + –

PDAC (Pricing, Data Analysis, and Coding) approval ensures that a brace meets Medicare’s strict requirements for quality, design, and function. Using PDAC-approved products simplifies reimbursement processes and helps avoid claim denials.

Where can I learn more about Medicare's requirements for braces and billing? + –

For more details on Medicare’s coding and reimbursement guidelines for orthotics, visit the official Medicare website below.
Medicare's DME Coverage

What is the CPT Code for a Custom-Fit Adjustable Ankle Foot Orthosis (AFO)?