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.