A5113 Leg Strap (HCPCS) Reimbursement & Policy | OpenPayer

Summary & Overview

HCPCS A5113: Leg Strap, Latex, Replacement Set

HCPCS Level II code A5113 designates a latex leg strap sold as a replacement set for durable medical equipment. Nationally, this code matters because replacement accessories for DME are common across home health, outpatient, and durable medical equipment supply environments and are subject to payer-specific coverage and reimbursement policies. Coverage decisions for accessory items like leg straps affect ongoing patient access to properly functioning mobility and therapeutic devices.

Key payers in the scope of this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what A5113 represents clinically, typical sites where the item is furnished, and the payer coverage landscape. The publication outlines expected benchmarks and use cases for replacement DME accessories, highlights common billing and documentation considerations, and summarizes current policy trends affecting accessory items under major national payers.

The piece is intended for billing specialists, DME suppliers, compliance staff, and policy analysts seeking a national perspective on how an accessory HCPCS Level II code for a latex leg strap is classified and managed across major payers. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareA5113HCPCS Level IIdurable medical equipmentDME accessoriesreplacement parthome health suppliesmedical billingreimbursement policy

Billing Code Overview

HCPCS Level II code A5113 describes a leg strap; latex, replacement only, per set. This code represents a durable medical equipment accessory used to secure or stabilize medical devices to the leg, supplied as a replacement set composed of latex material.

Service type: DME accessory / replacement part
Typical site of service: Durable medical equipment supply settings, outpatient clinics, home health supply deliveries

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A patient with an indwelling infusion or monitoring device requires a replacement set of leg straps used to secure tubing, sensors, or an external device to the thigh or calf. Typical patients include adults or pediatric patients receiving outpatient infusion therapy (e.g., chemotherapy, antibiotics, pain pumps), home infusion services, or ambulatory monitoring where a damaged or worn latex leg strap must be replaced. The workflow: a nurse or medical assistant inspects the device during a clinic visit or home nursing visit, documents wear or contamination of the existing A5113 leg strap, verifies device compatibility and ordering information, supplies and fits the replacement A5113 latex leg strap set, documents product lot and supplier, obtains patient acknowledgement of fit, and updates durable medical equipment records. Billing is for the replacement leg strap set only (A5113), provided as part of outpatient, home health, or infusion-center services; the strap is typically supplied by the DME supplier, clinic, or home health agency.

Coding Specifications

Modifier	Description	When to Use
`11`	Services by the treating physician	Use when the treating physician personally supplies and fits the replacement leg strap during an office visit.

HCPCS Level II A4248: Chlorhexidine Antiseptic, 1 ml

HCPCS-A6241-HYDROCOLLOID-WOUND-FILLER-PER-GRAM

HCPCS A6241: Hydrocolloid Wound Filler, Sterile, Per Gram

HCPCS-A6441-PADDING-BANDAGE-NON-ELASTIC-3-TO-5-INCH

HCPCS A6441: Padding Bandage, Non-Elastic 3–5 Inch

HCPCS-A4860-DISPOSABLE-CATHETER-TIPS-PERITONEAL-DIALYSIS-PER-10

HCPCS A4860: Disposable Catheter Tips for Peritoneal Dialysis, per 10

HCPCS-A6535-GRADIENT-COMPRESSION-STOCKING-THIGH-40MMHG

HCPCS A6535: Gradient Compression Stocking, Thigh Length, ≥40 mmHg

HCPCS-A6523-GRADIENT-COMPRESSION-ARM-PADDED-NIGHTTIME-CUSTOM

HCPCS A6523: Gradient Compression Arm Garment, Padded, Nighttime, Custom

HCPCS-LEVEL-II-A6580-GRADIENT-COMPRESSION-GLOVE-CUSTOM-HEAVY-WEIGHT

HCPCS Level II A6580: Gradient Compression Glove, Custom, Heavy Weight

HCPCS-A6262-WOUND-FILLER-DRY-FORM-PER-GRAM

HCPCS A6262: Wound Filler, Dry Form, Per Gram

HCPCS-A4594-NEUROMODULATION-MOUTHPIECE-ADJUNCT-REHAB

HCPCS A4594: Neuromodulation Stimulator Mouthpiece, Adjunct to Rehab Therapy

HCPCS-A4349-MALE-EXTERNAL-CATHETER-DISPOSABLE

HCPCS A4349: Male External Catheter, Disposable

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Taxonomy Code	Specialty	Notes
207Q00000X	Physical Therapist	Fits and recommends straps for mobility or rehabilitation devices.
3336C0006X	Home Health Agency	Provides replacement DME supplies during home visits.
363L00000X	Infusion Therapy	Infusion nurses and specialists who manage tubing securement and supplies.
208000000X	General Practice/Family Medicine	Office-based replacement during routine outpatient care.
207K00000X	Occupational Therapist	Assesses and fits straps for functional device use.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`Z46.89`	Encounter for fitting and adjustment of other specified devices	Common reason for supplying and fitting a replacement leg strap to secure medical devices.
`T85.79XA`	Failure and malfunction of other specified implanted devices and grafts, initial encounter	Relevant when external straps are replaced due to device malfunction necessitating securement adjustments.
`Z45.2`	Encounter for adjustment and management of vascular access device	Applies when leg straps are used to secure lines or ports associated with vascular access.
`Z48.02`	Encounter for removal of vascular catheter	May be present in the clinical context where device securement is adjusted or replaced following catheter procedures.
`L89.9`	Pressure ulcer of unspecified site, unspecified stage	Used when straps cause skin irritation or breakdown requiring strap replacement or adjustment.
`W19`	Unspecified fall, undetermined intent	Relevant when straps are replaced after trauma or device damage from a fall.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`96365`	Intravenous infusion, initial, up to 1 hour	May precede or coincide with `A5113` when leg strap secures infusion tubing during the infusion visit.
`36415`	Collection of venous blood by venipuncture	Performed during clinic visits where leg strap replacement may occur; both occur during the same encounter.
`99070`	Supplies and materials (except spectacles), non-covered items billed separately	Used by some payers to bill for disposable supplies; `A5113` is a HCPCS supply code and may be considered under supply billing practices.
`97602`	Debridement of open wounds, selective, without anesthesia	Wound care visits that require securement of dressing and device straps; replacement of `A5113` may occur in the same visit.
`99000`	Handling and/or conveyance of specimen	Ancillary service sometimes billed in visits involving device maintenance and associated testing.

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