HCPCS Code L4360: Walking Boot, Pneumatic and/or Vacuum, With or Without Joints, With or Without Interface Material, Prefabricated Item

Learn about the HCPCS code L4360 for a kind pneumatic/vacuum walking boot through this short guide.

## **What is the HCPCS code L4360 for?** The HCPCS code L4360 is meant to designate "Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise." The purpose of this medical/orthopedic walking boot is to stabilize a patient's foot and ankle. It also protects them. It's only meant to be provided to patients who are dealing with injuries or a musculoskeletal problem that requires the foot and ankle to be cushioned. It's also provided to patients who require rigid immobilization of their lower leg/foot and ankle (meaning, it'll be stuck in place). This boot can be customized based on the patient's needs and to accommodate any physical differences they have compared to other patients in general. For this walking boot specifically, it comes with a pneumatic support to provide compression and stabilization. It may also include rigid uprights and a rocker bottom sole to facilitate a more natural gait while protecting the affected foot/ankle.

## **Documentation requirements for L4360** Before filing for a claim for L4360, make sure to have sufficient documentation: - The full name of the patient - The full name of the provider who has had specialized training in fitting and adjusting (off-the-shelf) orthoses. - Patient's diagnosis showing an ailment that requires immobilization to justify the medical necessity - Documentation supporting why you opted for a walking boot that's custom-fitted versus one that isn't, or vice-versa - If the boot is custom-fitted or adjustments were required and made, document the professional involvement. - Documentation/notes how the walking boot supports the healing of the affected foot/ankle - Documentation that supports the choice of a pneumatic walking boot vs. a cast/non-pneumatic brace - Final fit measurements

## **Billing requirements for L4360** Besides the documentation above, please take note of the following: - One walking boot is equal to one unit - This is billed as a purchase, not rental - Make sure you code this correctly and use L4360. Don't use non-pneumatic orthoses codes - Make sure you are clear that the pneumatic walking boot is custom-fitted, not off-the-shelf Make sure you follow proper coding guidelines mandated by the CMS to avoid claim rejections

## **Other similar codes** - **L4386** - Walking boot, non-pneumatic, with or without joints, with or without interface material - **L4361** - Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material - **L4387** - Walking boot, non-pneumatic, with or without joints, with or without interface material - **L4631** - Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom - **L4396** - Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit

Frequently asked questions

The differentiating factor is the minimal self-adjustment. Prefabricated ones don't need the services of a certified orthotist or similar professional. Please see definitions set by Policy Article Coding Guidelines.

It can take up to an hour.

Yes. For orthoses in general, prolonged use can result in discomfort, skin irritation, and pressure sores, especially if the orthosis wasn't fitted properly.