HCPCS L3807: Wrist Hand Finger Orthosis, w/o Joint(s), Custom Fit

L3807 is a prefabricated device that must be substantially altered (e.g., heat molded, trimmed, bent with tools) by a certified professional to fit the patient's unique anatomy for a therapeutic outcome. L3809 is a prefabricated device that requires minimal or no professional adjustment, and the adjustments can be performed by the patient, caretaker, or supplier. The difference in the level of professional modification is the critical distinction for coding and reimbursement.

Yes, if they are considered "individuals with expertise" who perform the necessary custom-fitting modifications and the orthosis meets all the payer's guidelines, including coverage requirements and documentation. The rules for which provider types can bill for DME/orthotics vary by payer.

Yes, the code is all-inclusive. It covers the cost of the materials, the time spent for assessment, customization, fitting, adjustment, and patient instruction at the time of delivery. Separate billing for the fitting time is typically not allowed.