Ankle Foot Orthosis (AFO)

Medicare LCD L33686, Ankle-Foot/Knee-Ankle-Foot Orthoses, with Policy Article A52457 (also applies to L1952)

Covered when ordered for

• You are ambulatory (able to walk), and
• You have weakness or deformity of the foot and ankle that needs stabilization for medical reasons, and
• You have the potential to benefit functionally from the brace

Doctor's note should include

• The diagnosis and which side, for example foot drop, stroke, neuropathy or tendon dysfunction
• Exam findings showing weakness or deformity of the foot and ankle, such as dorsiflexion strength
• That you are ambulatory, and how the AFO will improve walking or safety
• Why stabilization of the foot and ankle is medically necessary

Prior authorization

Star DME checks whether Medicare requires prior authorization or a face-to-face visit for this brace before delivery, and submits the request for you if it does.