I understand that three different HCPCS codes are used in billing for diabetic inserts (made of the proper material, thickness, and durometer) when dispensing PDAC-approved diabetic shoes through DMERC: A5512, A5513, and A5514. I know that HCPCS code A5512 is a diabetic insert that must be heat molded to the patient's foot while weight-bearing with an external heat source (at a specific temperature), but my question is what is the difference between HCPCS codes A5513 versus A5514? I know that payment from DME is the same fee for both codes when billed. I am also aware these HCPCS codes represent a custom-molded diabetic foot insert (made of the correct material, thickness, and durometer). The techniques for obtaining the foot model for these inserts are different. I thought that the HCPCS code A5513 when billed was just obtaining a foot mold from plaster, foam box impression, or an STS sock and that the A5514 code was used only when scanning the foot using an application available from the DME vendor on an iPad. Is that correct? Please provide clarification with respect to these codes. Thanks
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I have seen manufacturers put on their invoices A5514, so knowing they are milling we only bill A5514 from our manufacturer.