L4360 Pneumat walking boot pre cstWalking 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
1 of 1 payer prior-auth lists that name L4360 require prior authorization or set conditions: Medicare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Medicare | DMEPOS Probationary Prior Authorization (new suppliers) | All | prior auth under conditions | Newly enrolled or changed-ownership suppliers in their probationary year | Oct 15, 2026 | DMEPOS Probationary Prior Authorization List |
L4360 appears in 5 coverage policies from Aetna, Anthem, Cigna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Ankle Orthoses, Ankle-Foot Orthoses (AFOs), and Knee-Ankle-Foot Orthoses (KAFOs) (0565) | covered if criteria are met | Aug 26, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | covered if criteria are met | Jan 20, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | listed, no stance (range L3650-L4398) | Jan 20, 2026 | payer document |
| Aetna | Plantar Fasciitis Treatments (0235) | listed, no stance (range L4350-L4398) | Apr 27, 2026 | payer document |
| Anthem | Ankle-Foot and Knee-Ankle-Foot Orthoses (CG-OR-PR-13) Orthoses | covered if criteria are met | Aug 13, 2026 | payer document |
| Cigna | Orthotic Devices and Shoes (0543) | covered if criteria are met | Sep 15, 2026 | payer document |
Prior authorization required or conditional in LA, MA, MS, OH, VA, WV.
From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.