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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l3202-child-orthopedic-oxford-shoe-supinator-pronator
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    HCPCS L3202: Orthopedic Shoe, Oxford, Child

    HCPCS Level II code L3202 describes an orthopedic shoe, oxford style, with supinator or pronator support for a child, representing a durable medical equipment item intended to provide foot and ankle support and corrective alignment; service type is orthopedic shoe fabrication/supply and typical site of service is outpatient orthotics/prosthetics clinic, pediatric orthopedics clinic, or durable medical equipment supplier.

    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 7-year-old child is referred by a pediatrician to a pediatric orthotist and pediatric orthopedic surgeon for symptomatic flexible pes planovalgus with excessive pronation and recurrent medial ankle pain that limits participation in school activities. After clinical exam and weight-bearing assessment, the orthotist performs a foot casting and fit evaluation for a custom pediatric orthopedic shoe with supinator/pronator control, documented as L3202. The workflow includes: initial evaluation by the pediatrician, referral to orthopedics, gait and foot alignment assessment, casting or scanning by the orthotist, fabrication and fitting of the L3202 orthopedic oxford with supinator or pronator elements, a follow-up fitting visit to assess comfort and alignment, and periodic adjustments over 3–6 months. Typical site of service is an outpatient orthotics/orthopedic clinic or hospital outpatient department. The service is provided for children needing shoe modification for biomechanical control when conservative measures such as physical therapy and orthotic inserts are insufficient. The expected documentation includes the diagnosis, functional limitations, measurement/cast, description of the device (L3202), delivery date, fitting notes, and follow-up plan.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99203Office or other outpatient visit for the evaluation and management of a new patient, typically 30 minutesUsed for initial orthopedics/orthotics evaluation and medical necessity documentation prior to ordering L3202
    97760Orthotic(s) management and training, initial encounterUsed when the orthotist provides fitting, training, and adjustment for the pediatric orthopedic shoe L3202
    99455Work related or medical disability examination by physician (for disability certification)May be used when functional footwear is documented as part of disability or school accommodation evaluations
    A9270Non-covered item or service (miscellaneous DME supply)Data not available in the input.
    11042Debridement, subcutaneous tissue (example)Data not available in the input.

    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…
    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…
    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…
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    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    103K00000XBehavior AnalystA behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential …
    202C00000XIndependent Medical Examiner PhysicianA special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practiti…
    246ZE0500XEEG Specialist/TechnologistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other
    224Z00000XOccupational Therapy AssistantAn occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council…
    251B00000XCase Management AgencyAn organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access…
    207PS0010XSports Medicine (Emergency Medicine) PhysicianAn emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the …

    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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