The Foot Defender is a revolutionary new product that was developed from podiatrist Jason Hanft who teamed with former Nike designer Michael DiTullo to create a product to address the diabetic epidemic which now totals over 200,000 amputations annually. The Foot Defender is designed to effectively offload the pressure points of the foot, easily be applied by patients, and increase compliance with modern appearance of todays footwear.
Ordering the Foot Defender for your patient.
The Foot Defender may be a covered benefit for patients when prescribed appropriately. Insurance plans are all unique, with their own set of guidelines that impact access to the Foot Defender. Each claim is processed independently by the patient’s insurance provider. Let’s first check eligibility:
How is the Foot Defender Boot coded by insurance?
The Foot Defender is approved to be billed under HCPCS code L4361 (Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf as maintained by CMS falls under Other Lower Extremity Orthotics).
**This code must be supported with documentation of an orthopedic diagnosis.
Why is the Foot Defender Boot marketed as offloading for DFU, but billed as orthopedic walking boot?
A HCPCS code for DFU offloading DME does not exist. HCPCS L4361 is only approved with an existing orthopedic code in the medical documentation. It is highly likely that DFU patients have underlying orthopedic diagnoses that impact their overall health and impact the genesis of a DFU.
What are common orthopedic codes that may lead to diabetic foot ulcers:
Osteoarthritis/Degenerative Joint Disease, Equinus, Contracture of foot, Unstable ankle, Instability of foot, foot drop.
What medical documentation is required to support submission of HCPCS L4361 (Foot Defender Boot)
- Supplemental Orthopedic diagnosis
a. This is a diagnosis for the product, not for the overall wound care treatment plan
- Documentation that patient is ambulatory.
- Documentation that patient has a weakness of deformity of the foot or ankle.
- Documentation that patient requires stabilization and have the potential to improve mobility and/or function by using the boot.
Can a patient with bilateral diabetic ulcer or recently healed ulcer receive two?
Yes, if they meet the requirement for both feet, they are eligible for two boots. Accompanying chart notes must support need.
When is the Foot Defender not covered by Medicare or insurance?
When patients who do not show the benefit of wound healing or gate improvement from this product use. Or those who have had a claim for a “Walking Boot”, “CAM Walker”, or other protective boot on the same foot within the past 5 years.
How to order using patient insurance benefits?
If you think your patient qualifies for a Foot Defender from the above guidelines? Let’s get started:
- Patient FACE sheet – insurance information, DOB, address, etc.
- Completed Rx with written orthopedic diagnosis code
- Medical documentation including information above
Order with 3rd party billing partners:
There are several methods for offloading pressure to the foot in patients with diabetic ulcers including bed rest, wheelchairs, walkers, total contact casting, and specialty walker boots. For ambulatory patients the preferred products are total contact casting and walker boots. Total contact casting has been proven to be effective at distributing pressure throughout the foot, but it is time consuming with a long learning curve. Walker boots have shown to be challenging for patients creating non-compliance with varying degree of success in reducing targeted pressure areas of the foot.
Foot Defender is an effective offloading device
Please review the comparative paper by Dr. Adam Landsman, DPM, PhD, FACFAS
Foot Defender is easy to use
Foot Defender looks great!
Aesthetics is one of the major hurdles of compliance for all products. Nothing comes close to the modern design of Foot Defender that also delivers on performance.