Tibial Fracture Orthosis (l2112)

There are two questions here requiring individual attention:

L2112: Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment already comes with a soft tissue interface. In addition because it is pre-fabricated, Medicare considers the device complete from a coding perspective and no other modifications can be added on to the device (at least from the billing and reimbursement perspective).

As for billing for it for other than a tibial fracture, while there is nothing in the LCD which precludes its use for a rearfoot or ankle (not including tibia) fracture.When the LCD does not limit coverage, one needs document medical necessity for a specific service, device or procedure. In this case, your documentation needs to support the use of a tibial fracture orthosis for a non-tibial fracture.

The answer is the same for L2114 and L2116 which are similar to L2112 but have greater degrees of rigidity.