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    v1.0.28
    OpenPayerBilling CodesOrthotic Procedures and servicesHCPCS hcpcs-l3219-orthopedic-mens-oxford-shoe
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    HCPCS L3219: Orthopedic Men’s Oxford Shoe, Each

    HCPCS Level II code L3219 describes an orthopedic men’s oxford shoe supplied as a single item; this HCPCS Level II code is used to bill for durable medical equipment footwear designed to provide orthopedic support and accommodation for medical foot conditions, typically provided as a custom or off-the-shelf therapeutic shoe for ambulatory use. Service type: orthopedic footwear (therapeutic shoe). Typical site of service: outpatient durable medical equipment supplier, orthotics/prosthetics clinic, or outpatient orthopedic clinic.

    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 68-year-old man with long-standing diabetic peripheral neuropathy and hallux valgus presents to a podiatry clinic for evaluation of chronic forefoot pain and recurrent plantar ulceration. Conservative measures including diabetic foot care education, therapeutic insoles, and custom orthoses have been partially effective but the patient continues to have pressure points and difficulty with ambulation in standard footwear. The podiatrist or orthotist performs a footwear assessment, documents the need for a medically indicated men’s orthopedic oxford shoe to accommodate a custom insert, offload pressure areas, and reduce ulcer recurrence. The clinical workflow includes: history and focused foot exam, gait and pressure assessment, measurement and casting or scanning if needed, documentation of medical necessity linked to an appropriate ICD-10 diagnosis, ordering the orthopedic shoe using billing code L3219, coordinating with a footwear vendor, delivery with fit check and patient education, and follow-up to confirm fit and clinical response.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    99213Office or other outpatient visit for evaluation and management of an established patient, typically 15 minutesCommon visit level for evaluation and documentation of medical necessity prior to ordering orthopedic footwear
    29580Unna boot application, below knee, with dressing and compression; initial applicationMay be used for concurrent wound management when foot ulcer offloading is needed prior to footwear fitting
    97110Therapeutic exercises to develop strength and endurance, range of motion and flexibilityOften performed by physical therapists to improve gait and conditioning complementary to orthotic footwear
    97602Removal of devitalized tissue (e.g., enzymatic, mechanical), selective debridement, open wound, without anesthesiaWound care procedures that can occur before prescribing orthopedic footwear for pressure offloading
    97035Ultrasound therapy, each 15 minutesAdjunctive therapy commonly used in wound healing programs when footwear is part of ulcer prevention

    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…
    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…
    63Modifier‑63 is appended to surgical CPT codes (20000–69990) when a procedure is performed on a neonate or infant weighing ≤ 4 kg (about 8.8 lbs). The AMA/AAPC definition specifies this use and notes…- Use modifier -63 only for surgical procedures in the CPT 20000–69990 series performed on a neonate or infant who weighs ≤ 4 kg at the time of the procedure; it indicates increased complexity due to…
    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…

    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…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    281P00000XChronic Disease Hospital(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of …
    2080P0204XPediatric Emergency Medicine (Pediatrics) PhysicianA pediatrician who has special qualifications to manage emergencies in infants and children.
    2084S0010XSports Medicine (Psychiatry & Neurology) PhysicianA psychiatrist or neurologist who specializes in the diagnosis and treatment of sports related conditions and injuries.
    207KI0005XClinical & Laboratory Immunology (Allergy & Immunology) PhysicianAn allergy and immunology physician who specializes in clinical and laboratory immunology disease management..
    111NT0100XThermography ChiropractorThe NUCC recommends this code not be used. Choose a more appropriate code.
    207SG0207XMedical Biochemical GeneticsA medical biochemical geneticist specializes in the diagnosis, evaluation, prevention, and treatment of patients with biochemical genetic disorders, d…

    Related ICD-10-CM Codes

    21 rows

    ICD-10-CM CodeDescription
    E10.621Type 1 diabetes mellitus with foot ulcer
    E11.52Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
    G57.61Lesion of plantar nerve, right lower limb
    G57.62Lesion of plantar nerve, left lower limb
    M17.11Unilateral primary osteoarthritis, right knee
    M17.12Unilateral primary osteoarthritis, left knee
    M24.571Contracture, right ankle
    M24.572Contracture, left ankle
    M25.571Pain in right ankle and joints of right foot
    M25.572Pain in left ankle and joints of left foot

    Showing 1–10 of 21

    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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