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    v1.0.31
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l2106-ankle-foot-fracture-cast-orthosis-custom-thermoplastic
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    HCPCS Level II L2106: Ankle-Foot Fracture Orthosis, Custom Thermoplastic

    HCPCS Level II code L2106 describes a custom-fabricated ankle-foot fracture orthosis (tibial fracture cast orthosis) made from thermoplastic casting material, used to immobilize and support the lower leg and ankle following tibial or ankle fractures; the service represents fabrication and provision of a custom AFO/short-leg fracture cast orthosis typically furnished in an outpatient orthotics/prosthetics clinic or hospital outpatient department and applied in settings where immobilization and fracture support are required.

    For related coverage guidance, see recent payer policy updates: Hospital Beds Corporate Medical Policy, Continuous Passive Motion Devices with Remote Monitoring or Adaptive Capabilities, Bone Growth Stimulators.

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    Clinical & Coding Specifications

    Clinical Context

    A 48-year-old male construction worker presents to an orthopedic clinic after sustaining a tibial shaft and distal fibular fracture following a fall from a ladder. Following initial evaluation with weight-bearing and non‑weight‑bearing radiographs, the treating orthopedic surgeon determines the injury is appropriate for a custom-fabricated thermoplastic tibial fracture cast orthosis (ankle–foot orthosis, fracture orthosis) to provide rigid immobilization while allowing limited soft-tissue access and easing wound care. The clinical workflow includes: referral to an orthotics technician or certified prosthetist-orthotist, patient measurement and casting or 3D scanning, custom fabrication of a thermoplastic AFO (custom fabricated), fitting and alignment in the clinic, education on wear schedule and skin inspection, and scheduled follow-up radiographs and clinic visits to assess fracture healing and adjust or discontinue the orthosis. Device provision is documented with diagnosis, device description L2106, manufacturer/serial numbers, and any applicable modifier to convey claim circumstances (for example, bilateral, reduced services, or unusual procedural effort). Typical site of service is an outpatient orthopedic clinic, hospital outpatient department, or dedicated orthotics/prosthetics facility, with potential supply coordination through durable medical equipment (DME) benefit for payors such as Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    29125Application of short leg splint (calf to foot)Initial temporary immobilization performed in the ED or clinic prior to custom orthosis fabrication.
    29515Application of fracture orthosis; tibial fracture cast orthosis (prefabricated)A related orthotic service for non‑custom or prefabricated options; contrasts with custom L2106 thermoplastic fabrication.
    29580Application of walker boot (prefabricated)Alternative immobilization frequently used before or instead of a custom AFO.
    99070Supplies and materials (over and above those usually included)Billing for additional nonstandard materials used during custom fabrication when payer allows.
    99083Physician standby service, per diemRarely used; may apply if prolonged observation or specialized supervision is required during fabrication fitting.

    Related Modifiers

    7 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    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…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    163W00000X
    213EP1101X
    2471Q0001X
    364SP2800X
    253J00000X
    133VN1401X
    207ZC0500X

    Related Payer Policy Updates

    Specialty: Durable Medical Equipment (DME)1 / 3

    10 rows

    PolicyPayerEffective Date
    Hospital Beds Corporate Medical Policybcbsvermont2027-01-01
    Continuous Passive Motion Devices with Remote Monitoring or Adaptive CapabilitiesBlue Cross Blue Shield - Rhode Island2026-12-01
    Bone Growth StimulatorsMass General Brigham Health Plan2026-12-01
    Prior Authorization for Durable Medical Equipment (DME)Blue Cross Blue Shield - Rhode Island2026-12-01
    Patient Liftsuniverahealthcare2026-11-16
    Medical Car SeatsCareSource2026-11-01
    Non-Invasive Home Mechanical Ventilation (E0466)CareSource2026-11-01
    Digestive Enzyme Cartridgeshusky_health2026-11-01
    Hearing Aids and Assistive Listening Devices for Children Enrolled in Birth-to-Threehusky_health2026-11-01
    Home Non-Invasive Positive Pressure Ventilation (NIPPV) Devices for Respiratory Insufficiency and Failureexcellus_health_plan_inc2026-10-15

    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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