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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l1930-prefabricated-ankle-foot-orthosis-fitting-adjustment
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    HCPCS L1930: Prefabricated Ankle-Foot Orthosis, Fitting and Adjustment

    HCPCS Level II code L1930 describes a prefabricated ankle-foot orthosis (AFO) made of plastic or other material and includes fitting and adjustment; service type: provision of a prefabricated orthotic device with clinical fitting; typical site of service: outpatient orthotics/prosthetics clinic or durable medical equipment supplier where the device is fitted and adjusted.

    For related coverage guidance, see recent payer policy updates: Interferential Stimulation Devices (for home use), Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical Guideline, Durable Medical Equipment (DME): Bone Growth Stimulators Medical Guideline.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult who presents to an outpatient orthopedic or podiatry clinic with ankle instability, foot drop, or neuromuscular weakness impairing ambulation. After a clinical evaluation by an orthopedic surgeon, physiatrist, or podiatrist, the provider documents functional deficits (gait instability, recurrent ankle sprains, or inability to dorsiflex the foot) and determines that an off‑the‑shelf ankle‑foot orthosis is appropriate. The orthotist or durable medical equipment (DME) supplier fits a prefabricated plastic AFO (L1930) during a clinic visit or in a DME shop; fitting includes adjustments to straps, padding, and rocker sole as needed for comfort and corrective positioning. The workflow typically includes: a physician or qualifying practitioner evaluation and order; measurement and fitting appointment with an orthotist or certified prosthetist; documentation of medical necessity, functional limitations, and gait assessment; delivery with in‑person fitting and adjustments; and follow‑up visits to monitor fit and function. Typical sites of service are outpatient hospital clinics, physician offices, and DME supplier facilities.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    97760Orthotic(s) management and training, initial encounter, face-to-face with the patient; fitting and trainingUsed when the orthotic device requires documented training and gait/functional instruction at delivery
    97763Orthotic(s) management and training, subsequent encounterUsed for follow-up visits providing ongoing training or adjustments after initial fitting
    99070Supplies and materials (except spectacles), provided by the physician or other qualified health care professionalUsed to bill for additional consumable supplies used during fitting (padding, straps) when payer allows
    99212Office or other outpatient visit for the evaluation and management of an established patient, low complexityCommon E/M level when the prescribing provider documents the clinical visit that results in the AFO order
    99213Office or other outpatient visit for the evaluation and management of an established patient, moderate complexityCommon E/M level when the prescribing visit includes medical decision making supporting medical necessity for L1930

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    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…
    [object Object]
    2PModifier -2P is a Category II performance‑measure exclusion appended to a CPT Category II (quality) code when the provider did not perform the measured action because of patient‑related reasons (for…- Use modifier 2P only with CPT Category II (performance‑measure) codes when a patient‑specific reason prevented performance of the measured action (for example, patient refusal, economic or social…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    2080P0208XPediatric Infectious Diseases PhysicianA pediatrician trained to care for children in the diagnosis, treatment and prevention of infectious diseases. This specialist can apply specific know…
    261Q00000XClinic/CenterA facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limite…
    213E00000XPodiatristA podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that l…
    332B00000XDurable Medical Equipment & Medical SuppliesA supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
    2080T0002XPediatric Medical Toxicology PhysicianMedical toxicologists are physicians that specialize in the prevention, evaluation, treatment and monitoring of injury and illness from exposures to d…
    2085U0001XDiagnostic Ultrasound PhysicianA Radiology doctor of Osteopathy that specializes in Diagnostic Ultrasound.
    246YC3301XHospital Based Coding SpecialistNone
    103TE1000XDeactivated - Psychologist

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    5 rows

    PolicyPayerEffective Date
    Interferential Stimulation Devices (for home use)Moda Health2026-10-01
    Durable Medical Equipment (DME): Tumor Treating Fields (Alternating Electric Field Therapy) Medical GuidelineWPS Health Insurance2026-10-01
    Durable Medical Equipment (DME): Bone Growth Stimulators Medical GuidelineWPS Health Insurance2026-10-01
    General Durable Medical Equipment (DME) Medical GuidelineWPS Health Insurance2026-10-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-10-01

    Related Codes

    HCPCS-L0112-CRANIAL-CERVICAL-ORTHOSIS-CONGENITAL-TORTICOLLIS-CUSTOM

    HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

    HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

    HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

    HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

    HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

    HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

    HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

    HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

    HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

    HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

    HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

    HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

    HCPCS Level II L0170: Cervical Collar, Custom-Molded

    HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

    HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

    HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

    HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

    HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

    HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

    Showing 1–10 of 466

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    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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