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    v1.0.30
    OpenPayerBilling CodesOtherHCPCS hcpcs-k0903-diabetic-custom-multiple-density-insert
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    HCPCS K0903: Diabetic Custom Multi-density Total Contact Insert

    HCPCS Level II code K0903 describes a custom-fabricated, multiple-density orthotic insert made for patients with diabetes using direct carving with CAM technology from a rectified CAD model created from a digitized scan of the patient; the device provides total contact with the foot including the arch, has a base layer of at least 3/16 inch of Shore A 35 (or higher) material, includes arch filler and shaping materials, and is intended as a custom diabetic foot insert (medical device service) typically provided by prosthetics/orthotics clinics or durable medical equipment suppliers in outpatient or clinic-based settings.

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    Table of contents

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    Clinical & Coding Specifications

    Clinical Context

    A 62-year-old patient with long-standing type 2 diabetes and peripheral neuropathy presents to a podiatry clinic with plantar forefoot and midfoot ulceration history and progressive foot deformity causing increased focal pressure. After a comprehensive foot evaluation, the podiatrist determines that a custom-molded, total-contact diabetic insert is required to offload high-pressure areas and accommodate an arch and deformity. The clinical workflow includes: referral or in-office assessment by a podiatrist or orthotist; obtaining a digitized scan of the patients foot using a 3D foot scanner; creation of a rectified CAD model; fabrication of a multiple-density insert by direct carving with CAM technology (minimum 3/16 inch shore A 35 base layer) including arch filler and shaping material; fitting the insert into the patients therapeutic shoe or diabetic footwear; and follow-up visits to assess fit, pressure relief, and ulcer healing.

    Typical site of service: outpatient podiatry clinic, orthotics/prosthetics facility, or specialty shoe center.

    Typical patient scenario: an ambulatory diabetic patient with peripheral neuropathy and prior plantar ulceration or high-risk foot deformity requiring a custom-fabricated total contact insert to reduce focal pressure and prevent recurrent ulceration. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99070Supplies and materials (e.g., equipment) provided by the physician over and above those usually included with the office visitUsed to bill for supplemental materials or components provided during fabrication or fitting when payor allows.
    97760Orthotic management and training; first visit for custom fitted or custom fabricated orthosis, upper or lower extremityUsed when the patient requires training and gait/pressure assessment at time of delivery of the custom insert.
    99456Work-related or medical disability examination services (note: choose appropriate evaluation code)May be used when documentation of functional impact or disability related to lower-extremity condition is required in the workflow.
    A9270Non-covered item or service (used per payor guidance)Some payors require this code when an item is non-covered or for tracking; local policy determines use.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    24Modifier 24 denotes an unrelated evaluation and management (E/M) service performed by the same physician or qualified healthcare professional during a postoperative global period. Per CPT guidance,…- Use modifier 24 when you report an evaluation and management (E/M) service performed by the same physician or same-specialty group during a procedure’s postoperative global period that is unrelated…
    25CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable…- When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207P00000X
    261QP2300X
    207L00000X
    183500000X
    146M00000X
    261QM0855X
    243U00000X
    2085R0205X

    Related ICD-10-CM Codes

    27 rows

    ICD-10-CM CodeDescription
    E10.51Type 1 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E10.621Type 1 diabetes mellitus with foot ulcer
    E10.9Type 1 diabetes mellitus without complications
    E11.40Type 2 diabetes mellitus with diabetic neuropathy, unspecified
    E11.42Type 2 diabetes mellitus with diabetic polyneuropathy
    E11.49Type 2 diabetes mellitus with other diabetic neurological complication
    E11.51Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
    E11.621Type 2 diabetes mellitus with foot ulcer
    E11.622Type 2 diabetes mellitus with other skin ulcer
    E11.65Type 2 diabetes mellitus with hyperglycemia

    Showing 1–10 of 27

    Related Codes

    HCPCS-C1300-HYPERBARIC-OXYGEN-FULL-BODY-CHAMBER-30MIN

    HCPCS Level II C1300: Hyperbaric Oxygen, Full‑Body Chamber, per 30 min

    HCPCS-K0901-KNEE-ORTHOSIS-SINGLE-UPRIGHT-PREFABRICATED

    HCPCS Level II K0901: Knee Orthosis, Single Upright, Prefabricated

    HCPCS-K0902-KNEE-ORTHOSIS-DOUBLE-UPRIGHT-PREFABRICATED-OTS

    HCPCS Level II K0902: Knee Orthosis, Double Upright, Prefabricated

    HCPCS-K1001-ELECTRONIC-POSITIONAL-OSA-TREATMENT-SENSOR

    HCPCS K1001: Electronic Positional Obstructive Sleep Apnea Treatment

    HCPCS-K1002-CRANIAL-ELECTROTHERAPY-STIMULATION-SYSTEM

    HCPCS K1002: Cranial Electrotherapy Stimulation System

    HCPCS-K1003-WHIRLPOOL-TUB-WALK-IN-PORTABLE

    HCPCS Level II K1003: Whirlpool Tub, Walk-In, Portable

    HCPCS-LEVEL-II-M1144-LIMITED-CONSULTATIVE-THERAPY-1-2-VISITS

    HCPCS Level II M1144: Ongoing Care Not Indicated, 1–2 Visits

    HCPCS-M0064-PSYCHIATRIC-MEDICATION-MANAGEMENT-BRIEF-OFFICE-VISIT

    HCPCS M0064: Brief Visit for Psychiatric Medication Monitoring

    HCPCS-M1000-PAIN-SCREEN-MODERATE-SEVERE

    HCPCS M1000: Pain Screened as Moderate to Severe

    HCPCS-M1001-PAIN-MANAGEMENT-PLAN-OF-CARE-MODERATE-SEVERE-PAIN

    HCPCS Level II M1001: Plan of Care for Moderate to Severe Pain

    Showing 1–10 of 16

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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