A5500 Diab shoe for density insert
Also known as: diabetic shoe with insert, custom diabetic shoe, density insert shoe
Custom-molded diabetic shoe with interior density insert for foot protection and pressure redistribution in patients with neuropathy.
In Plain Language
special diabetic shoe with padding; protective shoe for diabetic feet
Clinical Context
Prescribed for patients with diabetes mellitus and peripheral neuropathy to prevent ulcer formation, redistribute pressure, and protect at-risk feet. Requires face-to-face evaluation.
RVU Information
CPT A5500 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.
Billing & Documentation
HCPCS A-codes cover medical supplies, equipment, and transport services. Documentation must establish medical necessity and include a physician order. For durable medical equipment (DME), a Certificate of Medical Necessity (CMN) or detailed written order may be required.
Specialties
Frequently Asked Questions
What is CPT code A5500?
CPT A5500 (Diab shoe for density insert) is a A Codes code. Custom-molded diabetic shoe with interior density insert for foot protection and pressure redistribution in patients with neuropathy.
Does Medicare cover A5500?
Medicare coverage for A5500 depends on medical necessity and applicable Local Coverage Determinations (LCDs). Prescribed for patients with diabetes mellitus and peripheral neuropathy to prevent ulcer formation, redistribute pressure, and protect at-risk feet. Requires face-to-face evaluation. A physician order is typically required.
When is CPT A5500 used?
Prescribed for patients with diabetes mellitus and peripheral neuropathy to prevent ulcer formation, redistribute pressure, and protect at-risk feet. Requires face-to-face evaluation.
Track This Code in RVU Edge
Log procedures, calculate wRVUs, and benchmark against national data — all in one app.
CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.