| Field Name |
Field Value |
| Healthcare Common Procedure Coding System Code |
A5512 |
| HCPCS Sequence Number |
0010 |
| HCPCS Record Identification Code |
3 - First line of procedure record also contains detail information in positions 92-275 |
| HCPCS Long Description |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
| HCPCS Short Description |
Multi den insert direct form |
| HCPCS Pricing Indicator Code 1 |
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 Code |
C - Carrier judgment |
| HCPCS Berenson-Eggers Type Of Service Code |
D1F - Prosthetic/Orthotic devices |
| HCPCS Type Of Service Code 1 |
J - Diabetic shoes (eff 04/95) |
| HCPCS Anesthesia Base Unit Quantity |
0 |
| HCPCS Code Added Date |
1/1/2006 |
| HCPCS Action Effective Date |
1/1/2010 |
| HCPCS Action Code |
N - No maintenance for this code |