Custom Products

Custom Products

Custom Orthoses

Custom inserts are a sure way to guarantee total contact — particularly for patients with needs more complex than can be addressed with our heat-moldable or Gel Plus inserts.

Our lab can make custom inserts with off-loading areas, metatarsal pads, and more.

Custom Toe Fillers - L5000

Toe fillers provide proper biomechanical balance, support and protection for patients who have had partial foot amputations.4,5Each toe filler device is designed specifically for the patient and to fit into your patient’s footwear in an aesthetically pleasing manner. Toe fillers provide medial and lateral stability with distal stump protection and biomechanical balance to help provide the most natural ambulation. They are constructed of durable materials and have a semi-rigid prosthetic filler that maintains a soft accommodative surface for the foot.

Coding for Toe Fillers

Two separate benefit categories exist for shoe inserts used to accommodate missing digits (toes) for beneficiaries with and without diabetes. The codes L5000 and A5513 of the Healthcare Common Procedure Coding System (HCPCS) are used for these categories.

Please refer to: https://med.noridianmedicare.com/web/jadme/article-detail/-/view/2230703/toe-fillers-and-diabetic-shoe-inserts-coding-clarification for full clarification of this coding.

L5000 for Hallux Amputation

Provides medial and lateral stability with an EVA* fill in the hallux position to provide natural spring and biomechanical support. Designed to fit virtually any style of your patient’s footwear.

L5000 for Trans Metatarsal Amputation

Provides medial and lateral stability with distal stump protection and biomechanical support and natural toe spring with an EVA* fill in forefoot. Designed to fit virtually any style of your patient’s footwear.

Consider for:

Partial foot amputations such as toe and ray amputations and transmetatarsal amputations.4

Materials Used:

  • Soft trilament top cover with PU midlayer
  • Cork post for hindfoot and midfoot stability
  • Semi rigid EVA for toe filler portion

Custom Diabetic Inserts

As one of the world’s leading pedorthic laboratories, the Dr. Comfort® Custom Lab specializes in making high quality diabetic inserts. These types of inserts are often recommended to offer additional protection and accommodation of the diabetic foot from pressure, friction and skin trauma. Dr. Comfort inserts provide good arch fit and foot accommodation with a standard 15mm heel cup, minimum base thickness of 3/16” and a minimum of 35 durometer base with soft top covers. Special accommodations can be added per our accommodations and modifications chart.

Coding for Diabetic Inserts

Two separate codes exist for custom made diabetic inserts. The coding is now determined by the fabrication method of the inserts. Dr. Comfort Diabetic Inserts are primarily direct milled or carved, but we also reserve a molded technique for feet with severe deformities such as charcot joint.

Please refer to https://www.cgsmedicare.com/jc/pubs/news/2018/0218/cope6148.html for clarification of this coding.

PDAC Approved

The Pricing, Data Analysis and Coding (PDAC) contractor maintains the Durable Medical Equipment Coding System (DMECS). For more information on coding for Custom Diabetic Inserts, visit www.dmepdac.com

Custom Diabetic Inserts - Standard

Total contact accommodative insert with good arch control and a standard 15mm deep heel cup* for medial and lateral support.

Consider for:

Diabetes with callus formation, history of ulcerations, peripheral neuropathy and foot deformity

Material:
  • Top cover: Blue Soft top (standard), Pink/Blue bilam top
  • Base: Yellow 40 durometer , White 55 durometer (recommended for patient’s over 200lbs)

Custom Diabetic Inserts - With Special Accommodations

An intrinsic metatarsal pad and/or metatarsal offloading helps to reduce pressure on plantar abnormalities. The met pad helps by raising the area just proximal to the metatarsal heads to transfer the load and offloading helps by creating a depression in the insert for additional offloading.

Consider for:

Diabetes with callus formation, history of ulcerations, peripheral neuropathy and foot deformity

Material:
  • Top cover: Blue Soft top (standard), Pink/Blue bilam top
  • Base: Yellow 40 durometer , White 55 durometer (recommended for patient’s over 200lbs)
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