HCPCS Code L3913: Hand Finger Orthosis, Without Joints

Learn about the HCPCS code L3913 for "Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment."

Use Code

## **What is the HCPCS code L3913 for?** The HCPCS code description for L3913 is meant to designate a durable medical equipment in the form of a custom-fabricated orthosis for hands and fingers. This custom-fit orthosis may include a soft interface and straps. This service also includes fitting and adjustment for the specific patient availing of this orthosis. Fitting orthoses will be done by a trained orthotist or similar professional. What this orthosis does is primarily immobilize the hands and fingers. This helps alleviate pain and promote healing over time. It can also help prevent the hands and fingers from deformity and further injury. If it's not used for immobilization, it's used for support to help improve hand and finger function. This type of orthosis is issued to patients with the following problems or states: - Hand or finger sprains or fractures - Tendonitis of the hand - Tenosynovitis - Arthritis - Neurological problems that affect the hand and fingers - Post-surgery recovery for the hand/fingers The healthcare provider handling the patient will conduct an assessment to determine the specifications of the orthosis and make custom molds and measurements to ensure the final fitting is perfect for the patient's hands/fingers.

## **Documentation requirements for L3913** Before filing for a claim for L3913, please make sure you have sufficient documentation: - The full name of the patient receiving the orthosis - The full name and credentials of the healthcare providers involved in assessing the patient, and the fitting and customization of the orthosis - The patient's medical history and any relevant clinical indications and diagnoses to justify the medical necessity of the orthosis - Documentation that supports the substantial modification of the orthosis for the patient, and that customization was done by a certified orthotist or similarly trained professional at the time of delivery - Standard written order (SWO) or written order prior to delivery (WOPD) and proof of delivery - Hand/finger imaging test results (X-rays, MRIs, etc.) Please make sure that documentation aligns with the specifications mandated by any applicable Local Coverage Determination (LCD) for upper limb orthoses or the Medicare Program Integrity Manual.

## **Billing requirements for L3913** Besides the documentation requirements above, please make sure to prepare and take note of the following: - You have the appropriate codes (ICD codes, to be specific) based on the patient's condition - The use of either the RT or LT modifiers. RT for the right hand, LT for the left. If both hands require orthoses, submit two lines with RT and LT separately, each with one unit - This is a custom-fabricated orthosis, so no add-on orthotic codes should be billed alongside it Please follow CMS/relevant coding guidelines to avoid claim rejections.

## **Other similar codes** - **L3919** - Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment - **L3933** - Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment - **L3923** - Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise - **L3924** - Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf - **L3906** - Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment - **L4205** - Repair of orthotic device, labor component, per 15 minutes

Frequently asked questions

Orthopedists and rheumatologists are involved in assessing the patient's condition. Their results will be used by orthotists to create the necessary customizations for the patient.

It'll take a few days. The actual fitting will only take up to an hour.

Prolonged use of the orthosis will likely result in skin irritations and, worse, pressure sores. If the orthosis wasn't fitted properly, there will be discomfort the whole time, even beyond the adjustment period. It's also possible to have allergic reactions to the materials, but cases such as that are rare.