The device typically falls under L2136 code which is for a pre-fabricated knee-ankle-foot-orthosis (KAFO). It is intended to be used when a patient needs a “greater ability to ambulate independently” The code does not require pre-authorization and the Freedom Leg fits the definition well. We recommend that you include the following verbiage in your note when dispensing the Freedom Leg:
Dispensed KAFO. The patient is ambulatory with weakness and/or deformity of the foot and ankle whom additional knee stability is required, whom requires stabilization for medical reasons, and has the potential to benefit functionally. Secondary to these reasons I am prescribing a rigid, prefabricated Knee-Ankle-Foot Orthosis (L2136) for the patient. The purpose of the device is to stabilize gait and add rigid support to support. The goals of this device are to redistribute pressure, increase stability and allow the patient to have a greater ability to ambulate independently. The device is medically necessary for this patient’s condition, symptoms and current diagnosis. The device was fitted to the patient and it was noted to fit properly. The patient was educated as to proper use and care instructions for the device, and these were reviewed in detail. Written instructions were given. The patient signed a receipt and warranty information on the device. The patient states that the device was comfortable when fitted in the office and the patient was able to ambulate without distress in the knee-ankle-foot orthosis. At the time of dispensement, the device was suitable and not substandard.