Medical Billing Code Search
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9012 results found
| L3630 | Trans shoe solid stirrup new | Description: Transfer of an orthosis from one shoe to another, solid stirrup, new |
| L3640 | Shoe dennis browne splint bo | Description: Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes |
| L3649 | Orthopedic shoe modifica nos | Description: Orthopedic shoe, modification, addition or transfer, not otherwise specified |
| L3650 | So 8 abd restraint pre ots | Description: Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf |
| L3660 | So 8 ab rstr can/web pre ots | Description: Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
| L3670 | So acro/clav can web pre ots | Description: Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
| L3671 | So cap design w/o jnts cf | Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3674 | So airplane w/wo joint cf | Description: Shoulder orthosis, abduction positioning (airplane design), thoracic component and support bar, with or without nontorsion joint/turnbuckle, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3675 | So vest canvas/web pre ots | Description: Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf |
| L3677 | So hard plas stabili pre cst | Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3678 | So hard plas stabili pre ots | Description: Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| L3702 | Eo w/o joints cf | Description: Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3710 | Eo elas w/metal jnts pre ots | Description: Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf |
| L3720 | Forearm/arm cuffs free motio | Description: Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated |
| L3730 | Forearm/arm cuffs ext/flex a | Description: Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated |
| L3740 | Cuffs adj lock w/ active con | Description: Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated |
| L3760 | Eo adj jt prefab custom fit | Description: Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3761 | Eo, adj lock joint prefab ot | Description: Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf |
| L3762 | Eo rigid w/o joints pre ots | Description: Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf |
| L3763 | Ewho rigid w/o jnts cf | Description: Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3764 | Ewho w/joint(s) cf | Description: Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3765 | Ewhfo rigid w/o jnts cf | Description: Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3766 | Ewhfo w/joint(s) cf | Description: Elbow wrist hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3806 | Whfo w/joint(s) custom fab | Description: Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, custom fabricated, includes fitting and adjustment |
| L3807 | Whfo w/o joints pre cst | Description: Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3808 | Whfo, rigid w/o joints | Description: Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment |
| L3809 | Whfo w/o joints pre ots | Description: Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
| L3891 | Torsion mechanism wrist/elbo | Description: Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each |
| L3900 | Hinge extension/flex wrist/f | Description: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated |
| L3901 | Hinge ext/flex wrist finger | Description: Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated |
| L3904 | Whfo electric custom fitted | Description: Wrist hand finger orthosis, external powered, electric, custom fabricated |
| L3905 | Who w/nontorsion jnt(s) cf | Description: Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3906 | Who w/o joints cf | Description: Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3908 | Who cock-up nonmolde pre ots | Description: Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
| L3912 | Hfo flexion glove pre ots | Description: Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf |
| L3913 | Hfo w/o joints cf | Description: Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3915 | Who nontorsion jnts pre cst | Description: Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3916 | Who nontorsion jnts pre ots | Description: Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
| L3917 | Metacarp fx orthosis pre cst | Description: Hand orthosis, metacarpal fracture orthosis, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3918 | Metacarp fx orthosis pre ots | Description: Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf |
| L3919 | Ho w/o joints cf | Description: Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3921 | Hfo w/joint(s) cf | Description: Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3923 | Hfo without joints pre cst | Description: Hand finger orthosis, without joints, may include soft interface, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3924 | Hfo without joints pre ots | Description: Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf |
| L3925 | Fo pip dip jnt/sprng pre ots | Description: Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf |
| L3927 | Fo pip dip no jt spr pre ots | Description: Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), without joint/spring, extension/flexion (e.g., static or ring type), may include soft interface material, prefabricated, off-the-shelf |
| L3929 | Hfo nontorsion jnts pre cst | Description: Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L3930 | Hfo nontorsion jnts pre ots | Description: Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf |
| L3931 | Whfo nontorsion joint prefab | Description: Wrist hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, includes fitting and adjustment |
| L3933 | Fo w/o joints cf | Description: Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3935 | Fo nontorsion joint cf | Description: Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment |
| L3956 | Add joint upper ext orthosis | Description: Addition of joint to upper extremity orthosis, any material; per joint |
| L3960 | Sewho airplan desig abdu pos | Description: Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
| L3961 | Sewho cap design w/o jnts cf | Description: Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3962 | Sewho erbs palsey design abd | Description: Shoulder elbow wrist hand orthosis, abduction positioning, erb's palsey design, prefabricated, includes fitting and adjustment |
| L3967 | Sewho airplane w/o jnts cf | Description: Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3971 | Sewho cap design w/jnt(s) cf | Description: Shoulder elbow wrist hand orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3973 | Sewho airplane w/jnt(s) cf | Description: Shoulder elbow wrist hand orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3975 | Sewhfo cap design w/o jnt cf | Description: Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3976 | Sewhfo airplane w/o jnts cf | Description: Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3977 | Sewhfo cap desgn w/jnt(s) cf | Description: Shoulder elbow wrist hand finger orthosis, shoulder cap design, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3978 | Sewhfo airplane w/jnt(s) cf | Description: Shoulder elbow wrist hand finger orthosis, abduction positioning (airplane design), thoracic component and support bar, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment |
| L3980 | Up ext fx orthos humeral nos | Description: Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment |
| L3981 | Ue fx orth shoul cap forearm | Description: Upper extremity fracture orthosis, humeral, prefabricated, includes shoulder cap design, with or without joints, forearm section, may include soft interface, straps, includes fitting and adjustments |
| L3982 | Upper ext fx orthosis rad/ul | Description: Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment |
| L3984 | Upper ext fx orthosis wrist | Description: Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
| L3995 | Sock fracture or equal each | Description: Addition to upper extremity orthosis, sock, fracture or equal, each |
| L3999 | Upper limb orthosis nos | Description: Upper limb orthosis, not otherwise specified |
| L4000 | Repl girdle milwaukee orth | Description: Replace girdle for spinal orthosis (ctlso or so) |
| L4002 | Replace strap, any orthosis | Description: Replacement strap, any orthosis, includes all components, any length, any type |
| L4010 | Replace trilateral socket br | Description: Replace trilateral socket brim |
| L4020 | Replace quadlat socket brim | Description: Replace quadrilateral socket brim, molded to patient model |
| L4030 | Replace socket brim cust fit | Description: Replace quadrilateral socket brim, custom fitted |
| L4040 | Replace molded thigh lacer | Description: Replace molded thigh lacer, for custom fabricated orthosis only |
| L4045 | Replace non-molded thigh lac | Description: Replace non-molded thigh lacer, for custom fabricated orthosis only |
| L4050 | Replace molded calf lacer | Description: Replace molded calf lacer, for custom fabricated orthosis only |
| L4055 | Replace non-molded calf lace | Description: Replace non-molded calf lacer, for custom fabricated orthosis only |
| L4060 | Replace high roll cuff | Description: Replace high roll cuff |
| L4070 | Replace prox & dist upright | Description: Replace proximal and distal upright for kafo |
| L4080 | Repl met band kafo-afo prox | Description: Replace metal bands kafo, proximal thigh |
| L4090 | Repl met band kafo-afo calf/ | Description: Replace metal bands kafo-afo, calf or distal thigh |
| L4100 | Repl leath cuff kafo prox th | Description: Replace leather cuff kafo, proximal thigh |
| L4110 | Repl leath cuff kafo-afo cal | Description: Replace leather cuff kafo-afo, calf or distal thigh |
| L4130 | Replace pretibial shell | Description: Replace pretibial shell |
| L4205 | Ortho dvc repair per 15 min | Description: Repair of orthotic device, labor component, per 15 minutes |
| L4210 | Orth dev repair/repl minor p | Description: Repair of orthotic device, repair or replace minor parts |
| L4350 | Ankle control ortho pre ots | Description: Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf |
| L4360 | Pneumat walking boot pre cst | Description: Walking 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 |
| L4361 | Pneuma/vac walk boot pre ots | Description: Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4370 | Pneum full leg splnt pre ots | Description: Pneumatic full leg splint, prefabricated, off-the-shelf |
| L4386 | Non-pneum walk boot pre cst | Description: Walking boot, non-pneumatic, 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 |
| L4387 | Non-pneum walk boot pre ots | Description: Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
| L4392 | Replace afo soft interface | Description: Replacement, soft interface material, static afo |
| L4394 | Replace foot drop spint | Description: Replace soft interface material, foot drop splint |
| L4396 | Static or dynami afo pre cst | Description: Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
| L4397 | Static or dynami afo pre ots | Description: Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated, off-the-shelf |
| L4398 | Foot drop splint pre ots | Description: Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf |
| L4631 | Afo, walk boot type, cus fab | Description: Ankle foot orthosis, walking boot type, varus/valgus correction, rocker bottom, anterior tibial shell, soft interface, custom arch support, plastic or other material, includes straps and closures, custom fabricated |
| L5000 | Sho insert w arch toe filler | Description: Partial foot, shoe insert with longitudinal arch, toe filler |
| L5010 | Mold socket ank hgt w/ toe f | Description: Partial foot, molded socket, ankle height, with toe filler |
| L5020 | Tibial tubercle hgt w/ toe f | Description: Partial foot, molded socket, tibial tubercle height, with toe filler |
| L5050 | Ank symes mold sckt sach ft | Description: Ankle, symes, molded socket, sach foot |
| L5060 | Symes met fr leath socket ar | Description: Ankle, symes, metal frame, molded leather socket, articulated ankle/foot |
| L5100 | Molded socket shin sach foot | Description: Below knee, molded socket, shin, sach foot |
| L5105 | Plast socket jts/thgh lacer | Description: Below knee, plastic socket, joints and thigh lacer, sach foot |
| L5150 | Mold sckt ext knee shin sach | Description: Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot |
| L5160 | Mold socket bent knee shin s | Description: Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot |
| L5200 | Kne sing axis fric shin sach | Description: Above knee, molded socket, single axis constant friction knee, shin, sach foot |
| L5210 | No knee/ankle joints w/ ft b | Description: Above knee, short prosthesis, no knee joint ('stubbies'), with foot blocks, no ankle joints, each |
| L5220 | No knee joint with artic ali | Description: Above knee, short prosthesis, no knee joint ('stubbies'), with articulated ankle/foot, dynamically aligned, each |
| L5230 | Fem focal defic constant fri | Description: Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot |
| L5250 | Hip canad sing axi cons fric | Description: Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot |
| L5270 | Tilt table locking hip sing | Description: Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot |
| L5280 | Hemipelvect canad sing axis | Description: Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot |
| L5301 | Bk mold socket sach ft endo | Description: Below knee, molded socket, shin, sach foot, endoskeletal system |
| L5312 | Knee disart, sach ft, endo | Description: Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system |
| L5321 | Ak open end sach | Description: Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee |
| L5331 | Hip disart canadian sach ft | Description: Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot |
| L5341 | Hemipelvectomy canadian sach | Description: Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot |
| L5400 | Postop dress & 1 cast chg bk | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee |
| L5410 | Postop dsg bk ea add cast ch | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment |
| L5420 | Postop dsg & 1 cast chg ak/d | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change 'ak' or knee disarticulation |
| L5430 | Postop dsg ak ea add cast ch | Description: Immediate post surgical or early fitting, application of initial rigid dressing, incl. fitting, alignment and supension, 'ak' or knee disarticulation, each additional cast change and realignment |
| L5450 | Postop app non-wgt bear dsg | Description: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee |
| L5460 | Postop app non-wgt bear dsg | Description: Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee |
| L5500 | Init bk ptb plaster direct | Description: Initial, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed |
| L5505 | Init ak ischal plstr direct | Description: Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed |
| L5510 | Prep bk ptb plaster molded | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model |
| L5520 | Perp bk ptb thermopls direct | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed |
| L5530 | Prep bk ptb thermopls molded | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model |
| L5535 | Prep bk ptb open end socket | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket |
| L5540 | Prep bk ptb laminated socket | Description: Preparatory, below knee 'ptb' type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model |
| L5560 | Prep ak ischial plast molded | Description: Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model |
| L5570 | Prep ak ischial direct form | Description: Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed |
| L5580 | Prep ak ischial thermo mold | Description: Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model |
| L5585 | Prep ak ischial open end | Description: Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket |
| L5590 | Prep ak ischial laminated | Description: Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model |
| L5595 | Hip disartic sach thermopls | Description: Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model |
| L5600 | Hip disart sach laminat mold | Description: Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model |
| L5610 | Above knee hydracadence | Description: Addition to lower extremity, endoskeletal system, above knee, hydracadence system |
| L5611 | Ak 4 bar link w/fric swing | Description: Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control |
| L5613 | Ak 4 bar ling w/hydraul swig | Description: Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control |
| L5614 | 4-bar link above knee w/swng | Description: Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control |
| L5615 | Ak 4 bar link hydl swg/stanc | Description: Addition, endoskeletal knee-shin system, 4 bar linkage or multiaxial, fluid swing and stance phase control |
| L5616 | Ak univ multiplex sys frict | Description: Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control |
| L5617 | Ak/bk self-aligning unit ea | Description: Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each |
| L5618 | Test socket symes | Description: Addition to lower extremity, test socket, symes |
| L5620 | Test socket below knee | Description: Addition to lower extremity, test socket, below knee |
| L5622 | Test socket knee disarticula | Description: Addition to lower extremity, test socket, knee disarticulation |
| L5624 | Test socket above knee | Description: Addition to lower extremity, test socket, above knee |
| L5626 | Test socket hip disarticulat | Description: Addition to lower extremity, test socket, hip disarticulation |
| L5628 | Test socket hemipelvectomy | Description: Addition to lower extremity, test socket, hemipelvectomy |
| L5629 | Below knee acrylic socket | Description: Addition to lower extremity, below knee, acrylic socket |
| L5630 | Syme typ expandabl wall sckt | Description: Addition to lower extremity, symes type, expandable wall socket |
| L5631 | Ak/knee disartic acrylic soc | Description: Addition to lower extremity, above knee or knee disarticulation, acrylic socket |
| L5632 | Symes type ptb brim design s | Description: Addition to lower extremity, symes type, 'ptb' brim design socket |
| L5634 | Symes type poster opening so | Description: Addition to lower extremity, symes type, posterior opening (canadian) socket |
| L5636 | Symes type medial opening so | Description: Addition to lower extremity, symes type, medial opening socket |
| L5637 | Below knee total contact | Description: Addition to lower extremity, below knee, total contact |
| L5638 | Below knee leather socket | Description: Addition to lower extremity, below knee, leather socket |
| L5639 | Below knee wood socket | Description: Addition to lower extremity, below knee, wood socket |
| L5640 | Knee disarticulat leather so | Description: Addition to lower extremity, knee disarticulation, leather socket |
| L5642 | Above knee leather socket | Description: Addition to lower extremity, above knee, leather socket |
| L5643 | Hip flex inner socket ext fr | Description: Addition to lower extremity, hip disarticulation, flexible inner socket, external frame |
| L5644 | Above knee wood socket | Description: Addition to lower extremity, above knee, wood socket |
| L5645 | Bk flex inner socket ext fra | Description: Addition to lower extremity, below knee, flexible inner socket, external frame |
| L5646 | Below knee cushion socket | Description: Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket |
| L5647 | Below knee suction socket | Description: Addition to lower extremity, below knee suction socket |
| L5648 | Above knee cushion socket | Description: Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket |
| L5649 | Isch containmt/narrow m-l so | Description: Addition to lower extremity, ischial containment/narrow m-l socket |
| L5650 | Tot contact ak/knee disart s | Description: Additions to lower extremity, total contact, above knee or knee disarticulation socket |
| L5651 | Ak flex inner socket ext fra | Description: Addition to lower extremity, above knee, flexible inner socket, external frame |
| L5652 | Suction susp ak/knee disart | Description: Addition to lower extremity, suction suspension, above knee or knee disarticulation socket |
| L5653 | Knee disart expand wall sock | Description: Addition to lower extremity, knee disarticulation, expandable wall socket |
| L5654 | Socket insert symes | Description: Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal) |
| L5655 | Socket insert below knee | Description: Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal) |
| L5656 | Socket insert knee articulat | Description: Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal) |
| L5657 | Add low ext man aut vol any | Description: Addition to lower extremity prosthesis, manual/automated adjustable air, fluid, gel or equal socket insert for limb volume management, any materials |
| L5658 | Socket insert above knee | Description: Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal) |
| L5661 | Multi-durometer symes | Description: Addition to lower extremity, socket insert, multi-durometer symes |
| L5665 | Multi-durometer below knee | Description: Addition to lower extremity, socket insert, multi-durometer, below knee |
| L5666 | Below knee cuff suspension | Description: Addition to lower extremity, below knee, cuff suspension |
| L5668 | Bk molded distal cushion | Description: Addition to lower extremity, below knee, molded distal cushion |
| L5670 | Bk molded supracondylar susp | Description: Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar) |
| L5671 | Bk/ak locking mechanism | Description: Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
| L5672 | Bk removable medial brim sus | Description: Addition to lower extremity, below knee, removable medial brim suspension |
| L5673 | Socket insert w lock mech | Description: Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
| L5676 | Bk knee joints single axis p | Description: Additions to lower extremity, below knee, knee joints, single axis, pair |
| L5677 | Bk knee joints polycentric p | Description: Additions to lower extremity, below knee, knee joints, polycentric, pair |
| L5678 | Bk joint covers pair | Description: Additions to lower extremity, below knee, joint covers, pair |
| L5679 | Socket insert w/o lock mech | Description: Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, not for use with locking mechanism |
| L5680 | Bk thigh lacer non-molded | Description: Addition to lower extremity, below knee, thigh lacer, nonmolded |
| L5681 | Intl custm cong/latyp insert | Description: Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679) |
| L5682 | Bk thigh lacer glut/ischia m | Description: Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded |
| L5683 | Initial custom socket insert | Description: Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679) |
| L5684 | Bk fork strap | Description: Addition to lower extremity, below knee, fork strap |
| L5685 | Below knee sus/seal sleeve | Description: Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each |
| L5686 | Bk back check | Description: Addition to lower extremity, below knee, back check (extension control) |
| L5688 | Bk waist belt webbing | Description: Addition to lower extremity, below knee, waist belt, webbing |
| L5690 | Bk waist belt padded and lin | Description: Addition to lower extremity, below knee, waist belt, padded and lined |
| L5692 | Ak pelvic control belt light | Description: Addition to lower extremity, above knee, pelvic control belt, light |
| L5694 | Ak pelvic control belt pad/l | Description: Addition to lower extremity, above knee, pelvic control belt, padded and lined |
| L5695 | Ak sleeve susp neoprene/equa | Description: Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each |
| L5696 | Ak/knee disartic pelvic join | Description: Addition to lower extremity, above knee or knee disarticulation, pelvic joint |
| L5697 | Ak/knee disartic pelvic band | Description: Addition to lower extremity, above knee or knee disarticulation, pelvic band |
| L5698 | Ak/knee disartic silesian ba | Description: Addition to lower extremity, above knee or knee disarticulation, silesian bandage |
| L5699 | Shoulder harness | Description: All lower extremity prostheses, shoulder harness |
| L5700 | Replace socket below knee | Description: Replacement, socket, below knee, molded to patient model |
| L5701 | Replace socket above knee | Description: Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model |
| L5702 | Replace socket hip | Description: Replacement, socket, hip disarticulation, including hip joint, molded to patient model |
| L5703 | Symes ankle w/o (sach) foot | Description: Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only |
| L5704 | Custom shape cover bk | Description: Custom shaped protective cover, below knee |
| L5705 | Custom shape cover ak | Description: Custom shaped protective cover, above knee |
| L5706 | Custom shape cvr knee disart | Description: Custom shaped protective cover, knee disarticulation |
| L5707 | Custom shape cvr hip disart | Description: Custom shaped protective cover, hip disarticulation |
| L5710 | Kne-shin exo sng axi mnl loc | Description: Addition, exoskeletal knee-shin system, single axis, manual lock |
| L5711 | Knee-shin exo mnl lock ultra | Description: Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material |
| L5712 | Knee-shin exo frict swg & st | Description: Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) |
| L5714 | Knee-shin exo variable frict | Description: Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control |
| L5716 | Knee-shin exo mech stance ph | Description: Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock |
| L5718 | Knee-shin exo frct swg & sta | Description: Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control |
| L5722 | Knee-shin pneum swg frct exo | Description: Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control |
| L5724 | Knee-shin exo fluid swing ph | Description: Addition, exoskeletal knee-shin system, single axis, fluid swing phase control |
| L5726 | Knee-shin ext jnts fld swg e | Description: Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control |
| L5728 | Knee-shin fluid swg & stance | Description: Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control |
| L5780 | Knee-shin pneum/hydra pneum | Description: Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control |
| L5781 | Lower limb pros vacuum pump | Description: Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system |
| L5782 | Hd low limb pros vacuum pump | Description: Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty |
| L5783 | Add low ext mec limb vol lam | Description: Addition to lower extremity, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) |
| L5785 | Exoskeletal bk ultralt mater | Description: Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
| L5790 | Exoskeletal ak ultra-light m | Description: Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) |
| L5795 | Exoskel hip ultra-light mate | Description: Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) |
| L5810 | Endoskel knee-shin mnl lock | Description: Addition, endoskeletal knee-shin system, single axis, manual lock |
| L5811 | Endo knee-shin mnl lck ultra | Description: Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material |
| L5812 | Endo knee-shin frct swg & st | Description: Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) |
| L5814 | Endo knee-shin hydral swg ph | Description: Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock |
| L5816 | Endo knee-shin polyc mch sta | Description: Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock |
| L5818 | Endo knee-shin frct swg & st | Description: Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control |
| L5822 | Endo knee-shin pneum swg frc | Description: Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control |
| L5824 | Endo knee-shin fluid swing p | Description: Addition, endoskeletal knee-shin system, single axis, fluid swing phase control |
| L5826 | Miniature knee joint | Description: Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame |
| L5827 | Endo knee shin single axis | Description: Endoskeletal knee-shin system, single axis, electromechanical swing and stance phase control, with or without shock absorption and stance extension damping |
| L5828 | Endo knee-shin fluid swg/sta | Description: Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control |
| L5830 | Endo knee-shin pneum/swg pha | Description: Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control |
| L5840 | Multi-axial knee/shin system | Description: Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control |
| L5841 | Addition endoskletl knee-shi | Description: Addition, endoskeletal knee-shin system, polycentric, pneumatic swing, and stance phase control |
| L5845 | Knee-shin sys stance flexion | Description: Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable |
| L5848 | Knee-shin sys hydraul stance | Description: Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability |
| L5850 | Endo ak/hip knee extens assi | Description: Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist |
| L5855 | Mech hip extension assist | Description: Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist |
| L5856 | Elec knee-shin swing/stance | Description: Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type |
| L5857 | Elec knee-shin swing only | Description: Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type |
| L5858 | Stance phase only | Description: Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type |
| L5859 | Knee-shin pro flex/ext cont | Description: Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s) |
| L5910 | Endo below knee alignable sy | Description: Addition, endoskeletal system, below knee, alignable system |
| L5920 | Endo ak/hip alignable system | Description: Addition, endoskeletal system, above knee or hip disarticulation, alignable system |
| L5925 | Above knee manual lock | Description: Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock |
| L5926 | Endoskel posit rotat unit | Description: Addition to lower extremity prosthesis, endoskeletal, knee disarticulation, above knee, hip disarticulation, positional rotation unit, any type |
| L5930 | High activity knee frame | Description: Addition, endoskeletal system, high activity knee control frame |
| L5940 | Endo bk ultra-light material | Description: Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) |
| L5950 | Endo ak ultra-light material | Description: Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) |
| L5960 | Endo hip ultra-light materia | Description: Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) |
| L5961 | Endo poly hip, pneu/hyd/rot | Description: Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control |
| L5962 | Below knee flex cover system | Description: Addition, endoskeletal system, below knee, flexible protective outer surface covering system |
| L5964 | Above knee flex cover system | Description: Addition, endoskeletal system, above knee, flexible protective outer surface covering system |
| L5966 | Hip flexible cover system | Description: Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system |
| L5968 | Multiaxial ankle w dorsiflex | Description: Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature |
| L5969 | Ak/ft power asst incl motors | Description: Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s) |
| L5970 | Foot external keel sach foot | Description: All lower extremity prostheses, foot, external keel, sach foot |
| L5971 | Sach foot, replacement | Description: All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only |
| L5972 | Flexible keel foot | Description: All lower extremity prostheses, foot, flexible keel |
| L5973 | Ank-foot sys dors-plant flex | Description: Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source |
| L5974 | Foot single axis ankle/foot | Description: All lower extremity prostheses, foot, single axis ankle/foot |
| L5975 | Combo ankle/foot prosthesis | Description: All lower extremity prosthesis, combination single axis ankle and flexible keel foot |
| L5976 | Energy storing foot | Description: All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal) |
| L5978 | Ft prosth multiaxial ankl/ft | Description: All lower extremity prostheses, foot, multiaxial ankle/foot |
| L5979 | Multi-axial ankle/ft prosth | Description: All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system |
| L5980 | Flex foot system | Description: All lower extremity prostheses, flex foot system |
| L5981 | Flex-walk sys low ext prosth | Description: All lower extremity prostheses, flex-walk system or equal |
| L5982 | Exoskeletal axial rotation u | Description: All exoskeletal lower extremity prostheses, axial rotation unit |
| L5984 | Endoskeletal axial rotation | Description: All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability |
| L5985 | Lwr ext dynamic prosth pylon | Description: All endoskeletal lower extremity prostheses, dynamic prosthetic pylon |
| L5986 | Multi-axial rotation unit | Description: All lower extremity prostheses, multi-axial rotation unit ('mcp' or equal) |
| L5987 | Shank ft w vert load pylon | Description: All lower extremity prosthesis, shank foot system with vertical loading pylon |
| L5988 | Vertical shock reducing pylo | Description: Addition to lower limb prosthesis, vertical shock reducing pylon feature |
| L5990 | User adjustable heel height | Description: Addition to lower extremity prosthesis, user adjustable heel height |
| L5991 | Low pros ext osseo connector | Description: Addition to lower extremity prostheses, osseointegrated external prosthetic connector |
| L5999 | Lowr extremity prosthes nos | Description: Lower extremity prosthesis, not otherwise specified |
| L6000 | Part hand thumb rem | Description: Partial hand, thumb remaining |
| L6010 | Part hand little/ring | Description: Partial hand, little and/or ring finger remaining |
| L6020 | Part hand no fingers | Description: Partial hand, no finger remaining |
| L6025 | Part hand disart myoelectric | Description: Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device |
| L6026 | Part hand myo exclu term dev | Description: Transcarpal/metacarpal or partial hand disarticulation prosthesis, external power, self-suspended, inner socket with removable forearm section, electrodes and cables, two batteries, charger, myoelectric control of terminal device, excludes terminal device(s) |
| L6028 | Part hand finger metacar amp | Description: Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at metacarpal level, including flexible or non-flexible interface, molded to patient model, including palm, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692 |
| L6029 | Test interface part handfing | Description: Upper extremity addition, test socket/interface, partial hand including fingers |
| L6030 | External frame part handfing | Description: Upper extremity addition, external frame, partial hand including fingers |
| L6031 | Rep interface handfng molded | Description: Replacement socket/interface, partial hand including fingers, molded to patient model, for use with or without external power |
| L6032 | Part handfng ultralite tcf/= | Description: Addition to upper extremity prosthesis, partial hand including fingers, ultralight material (titanium, carbon fiber or equal) |
| L6033 | Part handfing acrylic | Description: Addition to upper extremity prosthesis, partial hand including fingers, acrylic material |
| L6034 | Part hand finger distal amp | Description: Partial hand, finger, and thumb prosthesis without prosthetic digit(s)/thumb, amputation at transmetacarpal level, including flexible or non-flexible interface, molded to patient model, for use without external power and/or passive prosthetic digit/thumb, not including inserts described by l6692 |
| L6035 | Prosthetic digit mechanical | Description: Single prosthetic digit, mechanical, can include metacarpophalangeal (mcp), proximal interphalangeal (pip), and/or distal interphalangeal (dip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement |
| L6036 | Prosthetic thumb mechanical | Description: Prosthetic thumb, mechanical, can include metacarpophalangeal (mcp), interphalangeal (ip) joint(s), with or without locking mechanism, can include flexion or extension assist, any material, attachment, initial issue or replacement |
| L6037 | Postop dsg cast chg handfing | Description: Immediate post-surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, partial hand including fingers |
| L6038 | Multiax rotation attachment | Description: Addition to single prosthetic digit or thumb, mechanical, attachment, multiaxial and/or internal/external rotation/abduction/adduction mechanism, with or without locking feature, any material |
| L6039 | Passive custom digit/thumb | Description: Passive prosthetic digit or thumb prosthesis not including hand restoration partial hand, full or partial, custom made, any material, initial or replacement, per single passive prosthetic digit or thumb |
| L6050 | Wrst mld sck flx hng tri pad | Description: Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad |
| L6055 | Wrst mold sock w/exp interfa | Description: Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad |
| L6100 | Elb mold sock flex hinge pad | Description: Below elbow, molded socket, flexible elbow hinge, triceps pad |
| L6110 | Elbow mold sock suspension t | Description: Below elbow, molded socket, (muenster or northwestern suspension types) |
| L6120 | Elbow mold doub splt soc ste | Description: Below elbow, molded double wall split socket, step-up hinges, half cuff |
| L6130 | Elbow stump activated lock h | Description: Below elbow, molded double wall split socket, stump activated locking hinge, half cuff |
| L6200 | Elbow mold outsid lock hinge | Description: Elbow disarticulation, molded socket, outside locking hinge, forearm |
| L6205 | Elbow molded w/ expand inter | Description: Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm |
| L6250 | Elbow inter loc elbow forarm | Description: Above elbow, molded double wall socket, internal locking elbow, forearm |
| L6300 | Shlder disart int lock elbow | Description: Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm |
| L6310 | Shoulder passive restor comp | Description: Shoulder disarticulation, passive restoration (complete prosthesis) |
| L6320 | Shoulder passive restor cap | Description: Shoulder disarticulation, passive restoration (shoulder cap only) |
| L6350 | Thoracic intern lock elbow | Description: Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm |
| L6360 | Thoracic passive restor comp | Description: Interscapular thoracic, passive restoration (complete prosthesis) |
| L6370 | Thoracic passive restor cap | Description: Interscapular thoracic, passive restoration (shoulder cap only) |
| L6380 | Postop dsg cast chg wrst/elb | Description: Immediate post surgical or early fitting, application of initial rigid dressing, including fitting alignment and suspension of components, and one cast change, wrist disarticulation or below elbow |
| L6382 | Postop dsg cast chg elb dis/ | Description: Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, elbow disarticulation or above elbow |
| L6384 | Postop dsg cast chg shlder/t | Description: Immediate post surgical or early fitting, application of initial rigid dressing including fitting alignment and suspension of components, and one cast change, shoulder disarticulation or interscapular thoracic |
| L6386 | Postop ea cast chg & realign | Description: Immediate post surgical or early fitting, each additional cast change and realignment |
| L6388 | Postop applicat rigid dsg on | Description: Immediate post surgical or early fitting, application of rigid dressing only |
| L6400 | Below elbow prosth tiss shap | Description: Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6450 | Elb disart prosth tiss shap | Description: Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6500 | Above elbow prosth tiss shap | Description: Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6550 | Shldr disar prosth tiss shap | Description: Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6570 | Scap thorac prosth tiss shap | Description: Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping |
| L6580 | Wrist/elbow bowden cable mol | Description: Preparatory, wrist disarticulation or below elbow, single wall plastic socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, molded to patient model |
| L6582 | Wrist/elbow bowden cbl dir f | Description: Preparatory, wrist disarticulation or below elbow, single wall socket, friction wrist, flexible elbow hinges, figure of eight harness, humeral cuff, bowden cable control, usmc or equal pylon, no cover, direct formed |
| L6584 | Elbow fair lead cable molded | Description: Preparatory, elbow disarticulation or above elbow, single wall plastic socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, molded to patient model |
| L6586 | Elbow fair lead cable dir fo | Description: Preparatory, elbow disarticulation or above elbow, single wall socket, friction wrist, locking elbow, figure of eight harness, fair lead cable control, usmc or equal pylon, no cover, direct formed |
| L6588 | Shdr fair lead cable molded | Description: Preparatory, shoulder disarticulation or interscapular thoracic, single wall plastic socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, molded to patient model |
| L6590 | Shdr fair lead cable direct | Description: Preparatory, shoulder disarticulation or interscapular thoracic, single wall socket, shoulder joint, locking elbow, friction wrist, chest strap, fair lead cable control, usmc or equal pylon, no cover, direct formed |
| L6600 | Polycentric hinge pair | Description: Upper extremity additions, polycentric hinge, pair |
| L6605 | Single pivot hinge pair | Description: Upper extremity additions, single pivot hinge, pair |
| L6610 | Flexible metal hinge pair | Description: Upper extremity additions, flexible metal hinge, pair |
| L6611 | Additional switch, ext power | Description: Addition to upper extremity prosthesis, external powered, additional switch, any type |
| L6615 | Disconnect locking wrist uni | Description: Upper extremity addition, disconnect locking wrist unit |
| L6616 | Disconnect insert locking wr | Description: Upper extremity addition, additional disconnect insert for locking wrist unit, each |
| L6620 | Flexion/extension wrist unit | Description: Upper extremity addition, flexion/extension wrist unit, with or without friction |
| L6621 | Flex/ext wrist w/wo friction | Description: Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device |
| L6623 | Spring-ass rot wrst w/ latch | Description: Upper extremity addition, spring assisted rotational wrist unit with latch release |
| L6624 | Flex/ext/rotation wrist unit | Description: Upper extremity addition, flexion/extension and rotation wrist unit |
| L6625 | Rotation wrst w/ cable lock | Description: Upper extremity addition, rotation wrist unit with cable lock |
| L6628 | Quick disconn hook adapter o | Description: Upper extremity addition, quick disconnect hook adapter, otto bock or equal |
| L6629 | Lamination collar w/ couplin | Description: Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal |
| L6630 | Stainless steel any wrist | Description: Upper extremity addition, stainless steel, any wrist |
| L6632 | Latex suspension sleeve each | Description: Upper extremity addition, latex suspension sleeve, each |
| L6635 | Lift assist for elbow | Description: Upper extremity addition, lift assist for elbow |
| L6637 | Nudge control elbow lock | Description: Upper extremity addition, nudge control elbow lock |
| L6638 | Elec lock on manual pw elbow | Description: Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow |
| L6640 | Shoulder abduction joint pai | Description: Upper extremity additions, shoulder abduction joint, pair |
| L6641 | Excursion amplifier pulley t | Description: Upper extremity addition, excursion amplifier, pulley type |
| L6642 | Excursion amplifier lever ty | Description: Upper extremity addition, excursion amplifier, lever type |
| L6645 | Shoulder flexion-abduction j | Description: Upper extremity addition, shoulder flexion-abduction joint, each |
| L6646 | Multipo locking shoulder jnt | Description: Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system |
| L6647 | Shoulder lock actuator | Description: Upper extremity addition, shoulder lock mechanism, body powered actuator |
| L6648 | Ext pwrd shlder lock/unlock | Description: Upper extremity addition, shoulder lock mechanism, external powered actuator |
| L6650 | Shoulder universal joint | Description: Upper extremity addition, shoulder universal joint, each |
| L6655 | Standard control cable extra | Description: Upper extremity addition, standard control cable, extra |
| L6660 | Heavy duty control cable | Description: Upper extremity addition, heavy duty control cable |
| L6665 | Teflon or equal cable lining | Description: Upper extremity addition, teflon, or equal, cable lining |
| L6670 | Hook to hand cable adapter | Description: Upper extremity addition, hook to hand, cable adapter |
| L6672 | Harness chest/shlder saddle | Description: Upper extremity addition, harness, chest or shoulder, saddle type |
| L6675 | Harness figure of 8 sing con | Description: Upper extremity addition, harness, (e.g., figure of eight type), single cable design |
| L6676 | Harness figure of 8 dual con | Description: Upper extremity addition, harness, (e.g., figure of eight type), dual cable design |
| L6677 | Ue triple control harness | Description: Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow |
| L6680 | Test sock wrist disart/bel e | Description: Upper extremity addition, test socket, wrist disarticulation or below elbow |
| L6682 | Test sock elbw disart/above | Description: Upper extremity addition, test socket, elbow disarticulation or above elbow |
| L6684 | Test socket shldr disart/tho | Description: Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic |
| L6686 | Suction socket | Description: Upper extremity addition, suction socket |
| L6687 | Frame typ socket bel elbow/w | Description: Upper extremity addition, frame type socket, below elbow or wrist disarticulation |
| L6688 | Frame typ sock above elb/dis | Description: Upper extremity addition, frame type socket, above elbow or elbow disarticulation |
| L6689 | Frame typ socket shoulder di | Description: Upper extremity addition, frame type socket, shoulder disarticulation |
| L6690 | Frame typ sock interscap-tho | Description: Upper extremity addition, frame type socket, interscapular-thoracic |
| L6691 | Removable insert each | Description: Upper extremity addition, removable insert, each |
| L6692 | Silicon gel insert w/wo lock | Description: Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each |
| L6693 | Lockingelbow forearm cntrbal | Description: Upper extremity addition, locking elbow, forearm counterbalance |
| L6694 | Elbow socket ins use w/lock | Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism |
| L6695 | Elbow socket ins use w/o lck | Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism |
| L6696 | Cus elbo skt in for con/atyp | Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695) |
| L6697 | Cus elbo skt in not con/atyp | Description: Addition to upper extremity prosthesis, below elbow/above elbow, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l6694 or l6695) |
| L6698 | Add up-ex prosthes lock mech | Description: Addition to upper extremity prosthesis, lock mechanism, excludes socket insert |
| L6700 | Ue add ext power myoel | Description: Upper extremity addition, external powered feature, myoelectronic control module, additional emg inputs, pattern-recognition decoding intent movement |
| L6703 | Term dev, passive hand mitt | Description: Terminal device, passive hand/mitt, any material, any size |
| L6704 | Term dev, sport/rec/work att | Description: Terminal device, sport/recreational/work attachment, any material, any size |
| L6706 | Term dev mech hook vol open | Description: Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined |
| L6707 | Term dev mech hook vol close | Description: Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined |
| L6708 | Term dev mech hand vol open | Description: Terminal device, hand, mechanical, voluntary opening, any material, any size |
| L6709 | Term dev mech hand vol close | Description: Terminal device, hand, mechanical, voluntary closing, any material, any size |
| L6711 | Ped term dev, hook, vol open | Description: Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric |
| L6712 | Ped term dev, hook, vol clos | Description: Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric |
| L6713 | Ped term dev, hand, vol open | Description: Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric |
| L6714 | Ped term dev, hand, vol clos | Description: Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric |
| L6715 | Term device, multi art digit | Description: Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement |
| L6721 | Hook/hand, hvy dty, vol open | Description: Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined |
| L6722 | Hook/hand, hvy dty, vol clos | Description: Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined |
| L6805 | Term dev modifier wrist unit | Description: Addition to terminal device, modifier wrist unit |
| L6810 | Term dev precision pinch dev | Description: Addition to terminal device, precision pinch device |
| L6880 | Elec hand ind art digits | Description: Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) |
| L6881 | Term dev auto grasp feature | Description: Automatic grasp feature, addition to upper limb electric prosthetic terminal device |
| L6882 | Microprocessor control uplmb | Description: Microprocessor control feature, addition to upper limb prosthetic terminal device |
| L6883 | Replc sockt below e/w disa | Description: Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power |
| L6884 | Replc sockt above elbow disa | Description: Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power |
| L6885 | Replc sockt shldr dis/interc | Description: Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power |
| L6890 | Prefab glove for term device | Description: Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment |
| L6895 | Custom glove for term device | Description: Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated |
| L6900 | Hand restorat thumb/1 finger | Description: Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining |
| L6905 | Hand restoration multiple fi | Description: Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining |
| L6910 | Hand restoration no fingers | Description: Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining |
| L6915 | Hand restoration replacmnt g | Description: Hand restoration (shading, and measurements included), replacement glove for above |
| L6920 | Wrist disarticul switch ctrl | Description: Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal, switch, cables, two batteries and one charger, switch control of terminal device |
| L6925 | Wrist disart myoelectronic c | Description: Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6930 | Below elbow switch control | Description: Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device |
| L6935 | Below elbow myoelectronic ct | Description: Below elbow, external power, self-suspended inner socket, removable forearm shell, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6940 | Elbow disarticulation switch | Description: Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device |
| L6945 | Elbow disart myoelectronic c | Description: Elbow disarticulation, external power, molded inner socket, removable humeral shell, outside locking hinges, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6950 | Above elbow switch control | Description: Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device |
| L6955 | Above elbow myoelectronic ct | Description: Above elbow, external power, molded inner socket, removable humeral shell, internal locking elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6960 | Shldr disartic switch contro | Description: Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device |
| L6965 | Shldr disartic myoelectronic | Description: Shoulder disarticulation, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L6970 | Interscapular-thor switch ct | Description: Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal switch, cables, two batteries and one charger, switch control of terminal device |
| L6975 | Interscap-thor myoelectronic | Description: Interscapular-thoracic, external power, molded inner socket, removable shoulder shell, shoulder bulkhead, humeral section, mechanical elbow, forearm, otto bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device |
| L7007 | Adult electric hand | Description: Electric hand, switch or myoelectric controlled, adult |
| L7008 | Pediatric electric hand | Description: Electric hand, switch or myoelectric, controlled, pediatric |
| L7009 | Adult electric hook | Description: Electric hook, switch or myoelectric controlled, adult |
| L7040 | Prehensile actuator | Description: Prehensile actuator, switch controlled |
| L7045 | Pediatric electric hook | Description: Electric hook, switch or myoelectric controlled, pediatric |
| L7170 | Electronic elbow hosmer swit | Description: Electronic elbow, hosmer or equal, switch controlled |
| L7180 | Electronic elbow sequential | Description: Electronic elbow, microprocessor sequential control of elbow and terminal device |
| L7181 | Electronic elbo simultaneous | Description: Electronic elbow, microprocessor simultaneous control of elbow and terminal device |
| L7185 | Electron elbow adolescent sw | Description: Electronic elbow, adolescent, variety village or equal, switch controlled |
| L7186 | Electron elbow child switch | Description: Electronic elbow, child, variety village or equal, switch controlled |
| L7190 | Elbow adolescent myoelectron | Description: Electronic elbow, adolescent, variety village or equal, myoelectronically controlled |
| L7191 | Elbow child myoelectronic ct | Description: Electronic elbow, child, variety village or equal, myoelectronically controlled |
| L7259 | Electronic wrist rotator any | Description: Electronic wrist rotator, any type |
| L7260 | Electron wrist rotator otto | Description: Electronic wrist rotator, otto bock or equal |
| L7261 | Electron wrist rotator utah | Description: Electronic wrist rotator, for utah arm |
| L7360 | Six volt bat otto bock/eq ea | Description: Six volt battery, each |
| L7362 | Battery chrgr six volt otto | Description: Battery charger, six volt, each |
| L7364 | Twelve volt battery utah/equ | Description: Twelve volt battery, each |
| L7366 | Battery chrgr 12 volt utah/e | Description: Battery charger, twelve volt, each |
| L7367 | Replacemnt lithium ionbatter | Description: Lithium ion battery, rechargeable, replacement |
| L7368 | Lithium ion battery charger | Description: Lithium ion battery charger, replacement only |
| L7400 | Add ue prost be/wd, ultlite | Description: Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) |
| L7401 | Add ue prost a/e ultlite mat | Description: Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) |
| L7402 | Add ue prost s/d ultlite mat | Description: Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) |
| L7403 | Add ue prost b/e acrylic | Description: Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material |
| L7404 | Add ue prost a/e acrylic | Description: Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material |
| L7405 | Add ue prost s/d acrylic | Description: Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material |
| L7406 | Add upp ext mec limb vol lam | Description: Addition to upper extremity prosthesis, user adjustable, mechanical, residual limb volume management system (with or without lamination kit) |
| L7499 | Upper extremity prosthes nos | Description: Upper extremity prosthesis, not otherwise specified |
| L7510 | Prosthetic device repair rep | Description: Repair of prosthetic device, repair or replace minor parts |
| L7520 | Repair prosthesis per 15 min | Description: Repair prosthetic device, labor component, per 15 minutes |
| L7600 | Prosthetic donning sleeve | Description: Prosthetic donning sleeve, any material, each |
| L7700 | Pros soc insert gasket/seal | Description: Gasket or seal, for use with prosthetic socket insert, any type, each |
| L7900 | Male vacuum erection system | Description: Male vacuum erection system |
| L7902 | Tension ring, vac erect dev | Description: Tension ring, for vacuum erection device, any type, replacement only, each |
| L8000 | Mastectomy bra | Description: Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
| L8001 | Breast prosthesis bra & form | Description: Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type |
| L8002 | Brst prsth bra & bilat form | Description: Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type |
| L8010 | Mastectomy sleeve | Description: Breast prosthesis, mastectomy sleeve |
| L8015 | Ext breastprosthesis garment | Description: External breast prosthesis garment, with mastectomy form, post mastectomy |
| L8020 | Mastectomy form | Description: Breast prosthesis, mastectomy form |
| L8030 | Breast prosthes w/o adhesive | Description: Breast prosthesis, silicone or equal, without integral adhesive |
| L8031 | Breast prosthesis w adhesive | Description: Breast prosthesis, silicone or equal, with integral adhesive |
| L8032 | Reusable nipple prosthesis | Description: Nipple prosthesis, prefabricated, reusable, any type, each |
| L8033 | Nipple prosthesis custom, ea | Description: Nipple prosthesis, custom fabricated, reusable, any material, any type, each |
| L8035 | Custom breast prosthesis | Description: Custom breast prosthesis, post mastectomy, molded to patient model |
| L8039 | Breast prosthesis nos | Description: Breast prosthesis, not otherwise specified |
| L8040 | Nasal prosthesis | Description: Nasal prosthesis, provided by a non-physician |
| L8041 | Midfacial prosthesis | Description: Midfacial prosthesis, provided by a non-physician |
| L8042 | Orbital prosthesis | Description: Orbital prosthesis, provided by a non-physician |
| L8043 | Upper facial prosthesis | Description: Upper facial prosthesis, provided by a non-physician |
| L8044 | Hemi-facial prosthesis | Description: Hemi-facial prosthesis, provided by a non-physician |
| L8045 | Auricular prosthesis | Description: Auricular prosthesis, provided by a non-physician |
| L8046 | Partial facial prosthesis | Description: Partial facial prosthesis, provided by a non-physician |
| L8047 | Nasal septal prosthesis | Description: Nasal septal prosthesis, provided by a non-physician |
| L8048 | Unspec maxillofacial prosth | Description: Unspecified maxillofacial prosthesis, by report, provided by a non-physician |
| L8049 | Repair maxillofacial prosth | Description: Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician |
| L8300 | Truss single w/ standard pad | Description: Truss, single with standard pad |
| L8310 | Truss double w/ standard pad | Description: Truss, double with standard pads |
| L8320 | Truss addition to std pad wa | Description: Truss, addition to standard pad, water pad |
| L8330 | Truss add to std pad scrotal | Description: Truss, addition to standard pad, scrotal pad |
| L8400 | Sheath below knee | Description: Prosthetic sheath, below knee, each |
| L8410 | Sheath above knee | Description: Prosthetic sheath, above knee, each |
| L8415 | Sheath upper limb | Description: Prosthetic sheath, upper limb, each |
| L8417 | Pros sheath/sock w gel cushn | Description: Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each |
| L8420 | Prosthetic sock multi ply bk | Description: Prosthetic sock, multiple ply, below knee, each |
| L8430 | Prosthetic sock multi ply ak | Description: Prosthetic sock, multiple ply, above knee, each |
| L8435 | Pros sock multi ply upper lm | Description: Prosthetic sock, multiple ply, upper limb, each |
| L8440 | Shrinker below knee | Description: Prosthetic shrinker, below knee, each |
| L8460 | Shrinker above knee | Description: Prosthetic shrinker, above knee, each |
| L8465 | Shrinker upper limb | Description: Prosthetic shrinker, upper limb, each |
| L8470 | Pros sock single ply bk | Description: Prosthetic sock, single ply, fitting, below knee, each |
| L8480 | Pros sock single ply ak | Description: Prosthetic sock, single ply, fitting, above knee, each |
| L8485 | Pros sock single ply upper l | Description: Prosthetic sock, single ply, fitting, upper limb, each |