Are there codes for billing insurance companies?

Will insurance companies cover the splints and what codes does one use? Yes, insurance companies may cover our splints but it depends on many variables. We do not bill insurance so the first step is to contact the provider and check what process one may need to follow to get the splints covered. The provider may be willing to reimburse the patient, or splints may need to be ordered through the measuring facility, orthotics company or durable medical equipment supplier (DME).

During the process, there may be a question about what “L” codes or “HCPCS” codes to use for SilverRing™ splints. Static finger splint codes are most often used. The following codes can be a good starting point in the discussion with the provider. These codes do not guarantee coverage or payment and do not replace your medical provider’s billing expertise. It is your responsibility to bill with the appropriate billing codes for the services and/or products provided. Based on feedback from individuals, our best advice is: Do not give up easily.

Since some people need multiple splints for each hand or finger, a more comprehensive “Letter of Medical Necessity” can be helpful. The form we provide is a generic letter to help the therapist, doctor or patient in the process of submitting to an insurance provider. It already includes the most common codes used for our splints.

Most forms have a field labeled Place of Service. Place of Service refers to the place where the patient will be using the device/orthosis/splint, not where the splint was measured. We recommend filling in this field with the numerical code for Home. We have seen code – 12 used for Home. It is the responsibility of the patient or therapist to check filing codes on any forms being submitted.

*The click here link at the end of each of the following lines takes you to a page for an exact definition and allows you to search by state to check Fee Schedules.

Custom Orthosis:

“L3933” –  Custom fabricated finger orthosis (click here)
“L3913” –  Custom fabricated hand finger orthosis
**Note: we have seen this code used for thumb splints** (click here)
“L3808” –  Custom fabricated wrist hand finger orthosis
**Note: we have seen this code used for thumb splints** (click here)
“E1399” – Durable medical equipment, miscellaneous (click here)
**Note: Code may only be valid if ordering through DME supplier. Not all facilities have a DME classification.

Other Splint Codes:

“Q4049” – Finger splint, static (click here)
“L3927” –  Prefabricated finger orthosis (click here)
“L3923” –  Prefabricated hand finger orthosis (click here)