OMB Memorandum: Managing Federal Contract Performance Issues Associated with the Novel Coronavirus (March 20th, 2020)
L0000–L9999: Orthotic and Prosthetic Procedures, Devices
HCPC | SEQNUM | RECID | LONG DESCRIPTION | SHORT DESCRIPTION |
---|---|---|---|---|
L0112 | 0010 | 3 | Cranial cervical orthosis, congenital torticollis type, with or without soft interface material, adjustable range of motion joint, custom fabricated | Cranial cervical orthosis |
L0113 | 0010 | 3 | Cranial cervical orthosis, torticollis type, with or without joint, with or without soft interface material, prefabricated, includes fitting and adjustment | Cranial cervical torticollis |
L0120 | 0010 | 3 | Cervical, flexible, non-adjustable, prefabricated, off-the-shelf (foam collar) | Cerv flex n/adj foam pre ots |
L0130 | 0010 | 3 | Cervical, flexible, thermoplastic collar, molded to patient | Flex thermoplastic collar mo |
L0140 | 0010 | 3 | Cervical, semi-rigid, adjustable (plastic collar) | Cervical semi-rigid adjustab |
L0150 | 0010 | 3 | Cervical, semi-rigid, adjustable molded chin cup (plastic collar with mandibular/occipital piece) | Cerv semi-rig adj molded chn |
L0160 | 0010 | 3 | Cervical, semi-rigid, wire frame occipital/mandibular support, prefabricated, off-the-shelf | Cerv sr wire occ/man pre ots |
L0170 | 0010 | 3 | Cervical, collar, molded to patient model | Cervical collar molded to pt |
L0172 | 0010 | 3 | Cervical, collar, semi-rigid thermoplastic foam, two-piece, prefabricated, off-the-shelf | Cerv col sr foam 2pc pre ots |
L0174 | 0010 | 3 | Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf | Cerv sr 2pc thor ext pre ots |
L0180 | 0010 | 3 | Cervical, multiple post collar, occipital/mandibular supports, adjustable | Cer post col occ/man sup adj |
L0190 | 0010 | 3 | Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars (somi, guilford, taylor types) | Cerv collar supp adj cerv ba |
L0200 | 0010 | 3 | Cervical, multiple post collar, occipital/mandibular supports, adjustable cervical bars, and thoracic extension | Cerv col supp adj bar & thor |
L0220 | 0010 | 3 | Thoracic, rib belt, custom fabricated | Thor rib belt custom fabrica |
L0450 | 0010 | 3 | Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf | Tlso flex trunk/thor pre ots |
L0452 | 0010 | 3 | Tlso, flexible, provides trunk support, upper thoracic region, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, custom fabricated | Tlso flex custom fab thoraci |
L0454 | 0010 | 3 | Tlso flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Tlso trnk sj-t9 pre cst |
L0455 | 0010 | 3 | Tlso, flexible, provides trunk support, extends from sacrococcygeal junction to above t-9 vertebra, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks with rigid stays or panel(s), includes shoulder straps and closures, prefabricated, off-the-shelf | Tlso flex trnk sj-t9 pre ots |
L0456 | 0010 | 3 | Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Tlso flex trnk sj-ss pre cst |
L0457 | 0010 | 3 | Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated, off-the-shelf | Tlso flex trnk sj-ss pre ots |
L0458 | 0010 | 3 | Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment | Tlso 2mod symphis-xipho pre |
L0460 | 0010 | 3 | Tlso, triplanar control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Tlso 2 shl symphys-stern cst |
L0462 | 0010 | 3 | Tlso, triplanar control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in the sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment | Tlso 3mod sacro-scap pre |
L0464 | 0010 | 3 | Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment | Tlso 4mod sacro-scap pre |
L0466 | 0010 | 3 | Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Tlso r fram soft ant pre cst |
L0467 | 0010 | 3 | Tlso, sagittal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, restricts gross trunk motion in sagittal plane, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf | Tlso r fram soft pre ots |
L0468 | 0010 | 3 | Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal, and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Tlso rig fram pelvic pre cst |
L0469 | 0010 | 3 | Tlso, sagittal-coronal control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction over scapulae, lateral strength provided by pelvic, thoracic, and lateral frame pieces, restricts gross trunk motion in sagittal and coronal planes, produces intracavitary pressure to reduce load on intervertebral disks, prefabricated, off-the-shelf | Tlso rig fram pelvic pre ots |
L0470 | 0010 | 3 | Tlso, triplanar control, rigid posterior frame and flexible soft anterior apron with straps, closures and padding, extends from sacrococcygeal junction to scapula, lateral strength provided by pelvic, thoracic, and lateral frame pieces, rotational strength provided by subclavicular extensions, restricts gross trunk motion in sagittal, coronal, and transverse planes, provides intracavitary pressure to reduce load on the intervertebral disks, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment | Tlso rigid frame pre subclav |
L0472 | 0010 | 3 | Tlso, triplanar control, hyperextension, rigid anterior and lateral frame extends from symphysis pubis to sternal notch with two anterior components (one pubic and one sternal), posterior and lateral pads with straps and closures, limits spinal flexion, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes fitting and shaping the frame, prefabricated, includes fitting and adjustment | Tlso rigid frame hyperex pre |
L0480 | 0010 | 3 | Tlso, triplanar control, one piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated | Tlso rigid plastic custom fa |
L0482 | 0010 | 3 | Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated | Tlso rigid lined custom fab |
L0484 | 0010 | 3 | Tlso, triplanar control, two piece rigid plastic shell without interface liner, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated | Tlso rigid plastic cust fab |
L0486 | 0010 | 3 | Tlso, triplanar control, two piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, lateral strength is enhanced by overlapping plastic, restricts gross trunk motion in the sagittal, coronal, and transverse planes, includes a carved plaster or cad-cam model, custom fabricated | Tlso rigidlined cust fab two |
L0488 | 0010 | 3 | Tlso, triplanar control, one piece rigid plastic shell with interface liner, multiple straps and closures, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to sternal notch, anterior or posterior opening, restricts gross trunk motion in sagittal, coronal, and transverse planes, prefabricated, includes fitting and adjustment | Tlso rigid lined pre one pie |
L0490 | 0010 | 3 | Tlso, sagittal-coronal control, one piece rigid plastic shell, with overlapping reinforced anterior, with multiple straps and closures, posterior extends from sacrococcygeal junction and terminates at or before the t-9 vertebra, anterior extends from symphysis pubis to xiphoid, anterior opening, restricts gross trunk motion in sagittal and coronal planes, prefabricated, includes fitting and adjustment | Tlso rigid plastic pre one |
L0491 | 0010 | 3 | Tlso, sagittal-coronal control, modular segmented spinal system, two rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment | Tlso 2 piece rigid shell |
L0492 | 0010 | 3 | Tlso, sagittal-coronal control, modular segmented spinal system, three rigid plastic shells, posterior extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, anterior extends from the symphysis pubis to the xiphoid, soft liner, restricts gross trunk motion in the sagittal and coronal planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment | Tlso 3 piece rigid shell |
L0621 | 0010 | 3 | Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf | Sio flex pelvic/sacr pre ots |
L0622 | 0010 | 3 | Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated | Sio flex pelvisacral custom |
L0623 | 0010 | 3 | Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf | Sio rig pnl pelv/sac pre ots |
L0624 | 0010 | 3 | Sacroiliac orthosis, provides pelvic-sacral support, with rigid or semi-rigid panels placed over the sacrum and abdomen, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated | Sio panel custom |
L0625 | 0010 | 3 | Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf | Lo flex l1-below l5 pre ots |
L0626 | 0010 | 3 | Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lo sag rig pnl stays pre cst |
L0627 | 0010 | 3 | Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lo sag ri an/pos pnl pre cst |
L0628 | 0010 | 3 | Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lso flex no ri stays pre ots |
L0629 | 0010 | 3 | Lumbar-sacral orthosis, flexible, provides lumbo-sacral support, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include stays, shoulder straps, pendulous abdomen design, custom fabricated | Lso flex w/rigid stays cust |
L0630 | 0010 | 3 | Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lso r post pnl sj-t9 pre cst |
L0631 | 0010 | 3 | Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lso sag r an/pos pnl pre cst |
L0632 | 0010 | 3 | Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated | Lso sag rigid frame cust |
L0633 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lso sc r pos/lat pnl pre cst |
L0634 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, custom fabricated | Lso flexion control custom |
L0635 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panel(s), lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, prefabricated, includes fitting and adjustment | Lso sagit rigid panel prefab |
L0636 | 0010 | 3 | Lumbar sacral orthosis, sagittal-coronal control, lumbar flexion, rigid posterior frame/panels, lateral articulating design to flex the lumbar spine, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, anterior panel, pendulous abdomen design, custom fabricated | Lso sagittal rigid panel cus |
L0637 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lso sc r ant/pos pnl pre cst |
L0638 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, custom fabricated | Lso sag-coronal panel custom |
L0639 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Lso s/c shell/panel prefab |
L0640 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, custom fabricated | Lso s/c shell/panel custom |
L0641 | 0010 | 3 | Lumbar orthosis, sagittal control, with rigid posterior panel(s), posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lo rig pos pnl l1-l5 pre ots |
L0642 | 0010 | 3 | Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lo sag ri an/pos pnl pre ots |
L0643 | 0010 | 3 | Lumbar-sacral orthosis, sagittal control, with rigid posterior panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lso sag ctr rigi pos pre ots |
L0648 | 0010 | 3 | Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lso sag r an/pos pnl pre ots |
L0649 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, stays, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lso sc r pos/lat pnl pre ots |
L0650 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf | Lso sc r ant/pos pnl pre ots |
L0651 | 0010 | 3 | Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf | Lso sag-co shell pnl pre ots |
L0700 | 0010 | 3 | Cervical-thoracic-lumbar-sacral-orthoses (ctlso), anterior-posterior-lateral control, molded to patient model, (minerva type) | Ctlso a-p-l control molded |
L0710 | 0010 | 3 | Ctlso, anterior-posterior-lateral-control, molded to patient model, with interface material, (minerva type) | Ctlso a-p-l control w/ inter |
L0810 | 0010 | 3 | Halo procedure, cervical halo incorporated into jacket vest | Halo cervical into jckt vest |
L0820 | 0010 | 3 | Halo procedure, cervical halo incorporated into plaster body jacket | Halo cervical into body jack |
L0830 | 0010 | 3 | Halo procedure, cervical halo incorporated into milwaukee type orthosis | Halo cerv into milwaukee typ |
L0859 | 0010 | 3 | Addition to halo procedure, magnetic resonance image compatible systems, rings and pins, any material | Mri compatible system |
L0861 | 0010 | 3 | Addition to halo procedure, replacement liner/interface material | Halo repl liner/interface |
L0970 | 0010 | 3 | Tlso, corset front | Tlso corset front |
L0972 | 0010 | 3 | Lso, corset front | Lso corset front |
L0974 | 0010 | 3 | Tlso, full corset | Tlso full corset |
L0976 | 0010 | 3 | Lso, full corset | Lso full corset |
L0978 | 0010 | 3 | Axillary crutch extension | Axillary crutch extension |
L0980 | 0010 | 3 | Peroneal straps, prefabricated, off-the-shelf, pair | Peroneal straps pair pre ots |
L0982 | 0010 | 3 | Stocking supporter grips, prefabricated, off-the-shelf, set of four (4) | Stocking sup grips 4 pre ots |
L0984 | 0010 | 3 | Protective body sock, prefabricated, off-the-shelf, each | Protect body sock ea pre ots |
L0999 | 0010 | 3 | Addition to spinal orthosis, not otherwise specified | Add to spinal orthosis nos |
L1000 | 0010 | 3 | Cervical-thoracic-lumbar-sacral orthosis (ctlso) (milwaukee), inclusive of furnishing initial orthosis, including model | Ctlso milwauke initial model |
L1001 | 0010 | 3 | Cervical thoracic lumbar sacral orthosis, immobilizer, infant size, prefabricated, includes fitting and adjustment | Ctlso infant immobilizer |
L1005 | 0010 | 3 | Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment | Tension based scoliosis orth |
L1010 | 0010 | 3 | Addition to cervical-thoracic-lumbar-sacral orthosis (ctlso) or scoliosis orthosis, axilla sling | Ctlso axilla sling |
L1020 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, kyphosis pad | Kyphosis pad |
L1025 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, kyphosis pad, floating | Kyphosis pad floating |
L1030 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, lumbar bolster pad | Lumbar bolster pad |
L1040 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, lumbar or lumbar rib pad | Lumbar or lumbar rib pad |
L1050 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, sternal pad | Sternal pad |
L1060 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, thoracic pad | Thoracic pad |
L1070 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, trapezius sling | Trapezius sling |
L1080 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, outrigger | Outrigger |
L1085 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, outrigger, bilateral with vertical extensions | Outrigger bil w/ vert extens |
L1090 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, lumbar sling | Lumbar sling |
L1100 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather | Ring flange plastic/leather |
L1110 | 0010 | 3 | Addition to ctlso or scoliosis orthosis, ring flange, plastic or leather, molded to patient model | Ring flange plas/leather mol |
L1120 | 0010 | 3 | Addition to ctlso, scoliosis orthosis, cover for upright, each | Covers for upright each |
L1200 | 0010 | 3 | Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only | Furnsh initial orthosis only |
L1210 | 0010 | 3 | Addition to tlso, (low profile), lateral thoracic extension | Lateral thoracic extension |
L1220 | 0010 | 3 | Addition to tlso, (low profile), anterior thoracic extension | Anterior thoracic extension |
L1230 | 0010 | 3 | Addition to tlso, (low profile), milwaukee type superstructure | Milwaukee type superstructur |
L1240 | 0010 | 3 | Addition to tlso, (low profile), lumbar derotation pad | Lumbar derotation pad |
L1250 | 0010 | 3 | Addition to tlso, (low profile), anterior asis pad | Anterior asis pad |
L1260 | 0010 | 3 | Addition to tlso, (low profile), anterior thoracic derotation pad | Anterior thoracic derotation |
L1270 | 0010 | 3 | Addition to tlso, (low profile), abdominal pad | Abdominal pad |
L1280 | 0010 | 3 | Addition to tlso, (low profile), rib gusset (elastic), each | Rib gusset (elastic) each |
L1290 | 0010 | 3 | Addition to tlso, (low profile), lateral trochanteric pad | Lateral trochanteric pad |
L1300 | 0010 | 3 | Other scoliosis procedure, body jacket molded to patient model | Body jacket mold to patient |
L1310 | 0010 | 3 | Other scoliosis procedure, post-operative body jacket | Post-operative body jacket |
L1499 | 0010 | 3 | Spinal orthosis, not otherwise specified | Spinal orthosis nos |
L1600 | 0010 | 3 | Hip orthosis, abduction control of hip joints, flexible, frejka type with cover, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an inidividual with expertise | Ho flex frejka w/cov pre cst |
L1610 | 0010 | 3 | Hip orthosis, abduction control of hip joints, flexible, (frejka cover only), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ho frejka cov only pre cst |
L1620 | 0010 | 3 | Hip orthosis, abduction control of hip joints, flexible, (pavlik harness), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ho flex pavlik harns pre cst |
L1630 | 0010 | 3 | Hip orthosis, abduction control of hip joints, semi-flexible (von rosen type), custom fabricated | Abduct control hip semi-flex |
L1640 | 0010 | 3 | Hip orthosis, abduction control of hip joints, static, pelvic band or spreader bar, thigh cuffs, custom fabricated | Pelv band/spread bar thigh c |
L1650 | 0010 | 3 | Hip orthosis, abduction control of hip joints, static, adjustable, (ilfled type), prefabricated, includes fitting and adjustment | Ho abduction hip adjustable |
L1652 | 0010 | 3 | Hip orthosis, bilateral thigh cuffs with adjustable abductor spreader bar, adult size, prefabricated, includes fitting and adjustment, any type | Ho bi thighcuffs w sprdr bar |
L1660 | 0010 | 3 | Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment | Ho abduction static plastic |
L1680 | 0010 | 3 | Hip orthosis, abduction control of hip joints, dynamic, pelvic control, adjustable hip motion control, thigh cuffs (rancho hip action type), custom fabricated | Pelvic & hip control thigh c |
L1685 | 0010 | 3 | Hip orthosis, abduction control of hip joint, postoperative hip abduction type, custom fabricated | Post-op hip abduct custom fa |
L1686 | 0010 | 3 | Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment | Ho post-op hip abduction |
L1690 | 0010 | 3 | Combination, bilateral, lumbo-sacral, hip, femur orthosis providing adduction and internal rotation control, prefabricated, includes fitting and adjustment | Combination bilateral ho |
L1700 | 0010 | 3 | Legg perthes orthosis, (toronto type), custom fabricated | Leg perthes orth toronto typ |
L1710 | 0010 | 3 | Legg perthes orthosis, (newington type), custom fabricated | Legg perthes orth newington |
L1720 | 0010 | 3 | Legg perthes orthosis, trilateral, (tachdijan type), custom fabricated | Legg perthes orthosis trilat |
L1730 | 0010 | 3 | Legg perthes orthosis, (scottish rite type), custom fabricated | Legg perthes orth scottish r |
L1755 | 0010 | 3 | Legg perthes orthosis, (patten bottom type), custom fabricated | Legg perthes patten bottom t |
L1810 | 0010 | 3 | Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ko elastic with joints |
L1812 | 0010 | 3 | Knee orthosis, elastic with joints, prefabricated, off-the-shelf | Ko elastic w/joints pre ots |
L1820 | 0010 | 3 | Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment | Ko elas w/ condyle pads & jo |
L1830 | 0010 | 3 | Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf | Ko immob canvas long pre ots |
L1831 | 0010 | 3 | Knee orthosis, locking knee joint(s), positional orthosis, prefabricated, includes fitting and adjustment | Knee orth pos locking joint |
L1832 | 0010 | 3 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ko adj jnt pos r sup pre cst |
L1833 | 0010 | 3 | Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf | Ko adj jnt pos r sup pre ots |
L1834 | 0010 | 3 | Knee orthosis, without knee joint, rigid, custom fabricated | Ko w/0 joint rigid molded to |
L1836 | 0010 | 3 | Knee orthosis, rigid, without joint(s), includes soft interface material, prefabricated, off-the-shelf | Ko rigid w/o joints pre ots |
L1840 | 0010 | 3 | Knee orthosis, derotation, medial-lateral, anterior cruciate ligament, custom fabricated | Ko derot ant cruciate custom |
L1843 | 0010 | 3 | Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ko single upright pre cst |
L1844 | 0010 | 3 | Knee orthosis, single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated | Ko w/adj jt rot cntrl molded |
L1845 | 0010 | 3 | Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ko double upright pre cst |
L1846 | 0010 | 3 | Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, custom fabricated | Ko w adj flex/ext rotat mold |
L1847 | 0010 | 3 | Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise | Ko dbl upright w/air pre cst |
L1848 | 0010 | 3 | Knee orthosis, double upright with adjustable joint, with inflatable air support chamber(s), prefabricated, off-the-shelf | Ko dbl upright w/air pre ots |
L1850 | 0010 | 3 | Knee orthosis, swedish type, prefabricated, off-the-shelf | Ko swedish type pre ots |
L1851 | 0010 | 3 | Knee orthosis (ko), single upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf | Ko single upright prefab ots |
L1852 | 0010 | 3 | Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf | Ko double upright prefab ots |
L1860 | 0010 | 3 | Knee orthosis, modification of supracondylar prosthetic socket, custom fabricated (sk) | Ko supracondylar socket mold |
L1900 | 0010 | 3 | Ankle foot orthosis, spring wire, dorsiflexion assist calf band, custom fabricated | Afo sprng wir drsflx calf bd |
L1902 | 0010 | 3 | Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf | Afo ankle gauntlet pre ots |
L1904 | 0010 | 3 | Ankle orthosis, ankle gauntlet or similar, with or without joints, custom fabricated | Afo molded ankle gauntlet |
L1906 | 0010 | 3 | Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf | Afo multilig ank sup pre ots |
L1907 | 0010 | 3 | Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated | Afo supramalleolar custom |
L1910 | 0010 | 3 | Ankle foot orthosis, posterior, single bar, clasp attachment to shoe counter, prefabricated, includes fitting and adjustment | Afo sing bar clasp attach sh |
L1920 | 0010 | 3 | Ankle foot orthosis, single upright with static or adjustable stop (phelps or perlstein type), custom fabricated | Afo sing upright w/ adjust s |
L1930 | 0010 | 3 | Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment | Afo plastic |
L1932 | 0010 | 3 | Afo, rigid anterior tibial section, total carbon fiber or equal material, prefabricated, includes fitting and adjustment | Afo rig ant tib prefab tcf/= |
L1940 | 0010 | 3 | Ankle foot orthosis, plastic or other material, custom fabricated | Afo molded to patient plasti |
L1945 | 0010 | 3 | Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated | Afo molded plas rig ant tib |
L1950 | 0010 | 3 | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic, custom fabricated | Afo spiral molded to pt plas |
L1951 | 0010 | 3 | Ankle foot orthosis, spiral, (institute of rehabilitative medicine type), plastic or other material, prefabricated, includes fitting and adjustment | Afo spiral prefabricated |
L1960 | 0010 | 3 | Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated | Afo pos solid ank plastic mo |
L1970 | 0010 | 3 | Ankle foot orthosis, plastic with ankle joint, custom fabricated | Afo plastic molded w/ankle j |
L1971 | 0010 | 3 | Ankle foot orthosis, plastic or other material with ankle joint, prefabricated, includes fitting and adjustment | Afo w/ankle joint, prefab |
L1980 | 0010 | 3 | Ankle foot orthosis, single upright free plantar dorsiflexion, solid stirrup, calf band/cuff (single bar ‘bk’ orthosis), custom fabricated | Afo sing solid stirrup calf |
L1990 | 0010 | 3 | Ankle foot orthosis, double upright free plantar dorsiflexion, solid stirrup, calf band/cuff (double bar ‘bk’ orthosis), custom fabricated | Afo doub solid stirrup calf |
L2000 | 0010 | 3 | Knee ankle foot orthosis, single upright, free knee, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ‘ak’ orthosis), custom fabricated | Kafo sing fre stirr thi/calf |
L2005 | 0010 | 3 | Knee ankle foot orthosis, any material, single or double upright, stance control, automatic lock and swing phase release, any type activation, includes ankle joint, any type, custom fabricated | Kafo sng/dbl mechanical act |
L2006 | 0010 | 3 | Knee ankle foot device, any material, single or double upright, swing and/or stance phase microprocessor control with adjustability, includes all components (e.g., sensors, batteries, charger), any type activation, with or without ankle joint(s), custom fabricated | Kaf sng/dbl swg/stn mcpr cus |
L2010 | 0010 | 3 | Knee ankle foot orthosis, single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar ‘ak’ orthosis), without knee joint, custom fabricated | Kafo sng solid stirrup w/o j |
L2020 | 0010 | 3 | Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs (double bar ‘ak’ orthosis), custom fabricated | Kafo dbl solid stirrup band/ |
L2030 | 0010 | 3 | Knee ankle foot orthosis, double upright, free ankle, solid stirrup, thigh and calf bands/cuffs, (double bar ‘ak’ orthosis), without knee joint, custom fabricated | Kafo dbl solid stirrup w/o j |
L2034 | 0010 | 3 | Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, medial lateral rotation control, with or without free motion ankle, custom fabricated | Kafo pla sin up w/wo k/a cus |
L2035 | 0010 | 3 | Knee ankle foot orthosis, full plastic, static (pediatric size), without free motion ankle, prefabricated, includes fitting and adjustment | Kafo plastic pediatric size |
L2036 | 0010 | 3 | Knee ankle foot orthosis, full plastic, double upright, with or without free motion knee, with or without free motion ankle, custom fabricated | Kafo plas doub free knee mol |
L2037 | 0010 | 3 | Knee ankle foot orthosis, full plastic, single upright, with or without free motion knee, with or without free motion ankle, custom fabricated | Kafo plas sing free knee mol |
L2038 | 0010 | 3 | Knee ankle foot orthosis, full plastic, with or without free motion knee, multi-axis ankle, custom fabricated | Kafo w/o joint multi-axis an |
L2040 | 0010 | 3 | Hip knee ankle foot orthosis, torsion control, bilateral rotation straps, pelvic band/belt, custom fabricated | Hkafo torsion bil rot straps |
L2050 | 0010 | 3 | Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, hip joint, pelvic band/belt, custom fabricated | Hkafo torsion cable hip pelv |
L2060 | 0010 | 3 | Hip knee ankle foot orthosis, torsion control, bilateral torsion cables, ball bearing hip joint, pelvic band/ belt, custom fabricated | Hkafo torsion ball bearing j |
L2070 | 0010 | 3 | Hip knee ankle foot orthosis, torsion control, unilateral rotation straps, pelvic band/belt, custom fabricated | Hkafo torsion unilat rot str |
L2080 | 0010 | 3 | Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, hip joint, pelvic band/belt, custom fabricated | Hkafo unilat torsion cable |
L2090 | 0010 | 3 | Hip knee ankle foot orthosis, torsion control, unilateral torsion cable, ball bearing hip joint, pelvic band/ belt, custom fabricated | Hkafo unilat torsion ball br |
L2106 | 0010 | 3 | Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, thermoplastic type casting material, custom fabricated | Afo tib fx cast plaster mold |
L2108 | 0010 | 3 | Ankle foot orthosis, fracture orthosis, tibial fracture cast orthosis, custom fabricated | Afo tib fx cast molded to pt |
L2112 | 0010 | 3 | Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, soft, prefabricated, includes fitting and adjustment | Afo tibial fracture soft |
L2114 | 0010 | 3 | Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment | Afo tib fx semi-rigid |
L2116 | 0010 | 3 | Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, rigid, prefabricated, includes fitting and adjustment | Afo tibial fracture rigid |
L2126 | 0010 | 3 | Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, thermoplastic type casting material, custom fabricated | Kafo fem fx cast thermoplas |
L2128 | 0010 | 3 | Knee ankle foot orthosis, fracture orthosis, femoral fracture cast orthosis, custom fabricated | Kafo fem fx cast molded to p |
L2132 | 0010 | 3 | Kafo, fracture orthosis, femoral fracture cast orthosis, soft, prefabricated, includes fitting and adjustment | Kafo femoral fx cast soft |
L2134 | 0010 | 3 | Kafo, fracture orthosis, femoral fracture cast orthosis, semi-rigid, prefabricated, includes fitting and adjustment | Kafo fem fx cast semi-rigid |
L2136 | 0010 | 3 | Kafo, fracture orthosis, femoral fracture cast orthosis, rigid, prefabricated, includes fitting and adjustment | Kafo femoral fx cast rigid |
L2180 | 0010 | 3 | Addition to lower extremity fracture orthosis, plastic shoe insert with ankle joints | Plas shoe insert w ank joint |
L2182 | 0010 | 3 | Addition to lower extremity fracture orthosis, drop lock knee joint | Drop lock knee |
L2184 | 0010 | 3 | Addition to lower extremity fracture orthosis, limited motion knee joint | Limited motion knee joint |
L2186 | 0010 | 3 | Addition to lower extremity fracture orthosis, adjustable motion knee joint, lerman type | Adj motion knee jnt lerman t |
L2188 | 0010 | 3 | Addition to lower extremity fracture orthosis, quadrilateral brim | Quadrilateral brim |
L2190 | 0010 | 3 | Addition to lower extremity fracture orthosis, waist belt | Waist belt |
L2192 | 0010 | 3 | Addition to lower extremity fracture orthosis, hip joint, pelvic band, thigh flange, and pelvic belt | Pelvic band & belt thigh fla |
L2200 | 0010 | 3 | Addition to lower extremity, limited ankle motion, each joint | Limited ankle motion ea jnt |
L2210 | 0010 | 3 | Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint | Dorsiflexion assist each joi |
L2220 | 0010 | 3 | Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint | Dorsi & plantar flex ass/res |
L2230 | 0010 | 3 | Addition to lower extremity, split flat caliper stirrups and plate attachment | Split flat caliper stirr & p |
L2232 | 0010 | 3 | Addition to lower extremity orthosis, rocker bottom for total contact ankle foot orthosis, for custom fabricated orthosis only | Rocker bottom, contact afo |
L2240 | 0010 | 3 | Addition to lower extremity, round caliper and plate attachment | Round caliper and plate atta |
L2250 | 0010 | 3 | Addition to lower extremity, foot plate, molded to patient model, stirrup attachment | Foot plate molded stirrup at |
L2260 | 0010 | 3 | Addition to lower extremity, reinforced solid stirrup (scott-craig type) | Reinforced solid stirrup |
L2265 | 0010 | 3 | Addition to lower extremity, long tongue stirrup | Long tongue stirrup |
L2270 | 0010 | 3 | Addition to lower extremity, varus/valgus correction (‘t’) strap, padded/lined or malleolus pad | Varus/valgus strap padded/li |
L2275 | 0010 | 3 | Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined | Plastic mod low ext pad/line |
L2280 | 0010 | 3 | Addition to lower extremity, molded inner boot | Molded inner boot |
L2300 | 0010 | 3 | Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable | Abduction bar jointed adjust |
L2310 | 0010 | 3 | Addition to lower extremity, abduction bar-straight | Abduction bar-straight |
L2320 | 0010 | 3 | Addition to lower extremity, non-molded lacer, for custom fabricated orthosis only | Non-molded lacer |
L2330 | 0010 | 3 | Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only | Lacer molded to patient mode |
L2335 | 0010 | 3 | Addition to lower extremity, anterior swing band | Anterior swing band |
L2340 | 0010 | 3 | Addition to lower extremity, pre-tibial shell, molded to patient model | Pre-tibial shell molded to p |
L2350 | 0010 | 3 | Addition to lower extremity, prosthetic type, (bk) socket, molded to patient model, (used for ‘ptb’ ‘afo’ orthoses) | Prosthetic type socket molde |
L2360 | 0010 | 3 | Addition to lower extremity, extended steel shank | Extended steel shank |
L2370 | 0010 | 3 | Addition to lower extremity, patten bottom | Patten bottom |
L2375 | 0010 | 3 | Addition to lower extremity, torsion control, ankle joint and half solid stirrup | Torsion ank & half solid sti |
L2380 | 0010 | 3 | Addition to lower extremity, torsion control, straight knee joint, each joint | Torsion straight knee joint |
L2385 | 0010 | 3 | Addition to lower extremity, straight knee joint, heavy duty, each joint | Straight knee joint heavy du |
L2387 | 0010 | 3 | Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint | Add le poly knee custom kafo |
L2390 | 0010 | 3 | Addition to lower extremity, offset knee joint, each joint | Offset knee joint each |
L2395 | 0010 | 3 | Addition to lower extremity, offset knee joint, heavy duty, each joint | Offset knee joint heavy duty |
L2397 | 0010 | 3 | Addition to lower extremity orthosis, suspension sleeve | Suspension sleeve lower ext |
L2405 | 0010 | 3 | Addition to knee joint, drop lock, each | Knee joint drop lock ea jnt |
L2415 | 0010 | 3 | Addition to knee lock with integrated release mechanism (bail, cable, or equal), any material, each joint | Knee joint cam lock each joi |
L2425 | 0010 | 3 | Addition to knee joint, disc or dial lock for adjustable knee flexion, each joint | Knee disc/dial lock/adj flex |
L2430 | 0010 | 3 | Addition to knee joint, ratchet lock for active and progressive knee extension, each joint | Knee jnt ratchet lock ea jnt |
L2492 | 0010 | 3 | Addition to knee joint, lift loop for drop lock ring | Knee lift loop drop lock rin |
L2500 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, gluteal/ ischial weight bearing, ring | Thi/glut/ischia wgt bearing |
L2510 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, molded to patient model | Th/wght bear quad-lat brim m |
L2520 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, quadri- lateral brim, custom fitted | Th/wght bear quad-lat brim c |
L2525 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim molded to patient model | Th/wght bear nar m-l brim mo |
L2526 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, ischial containment/narrow m-l brim, custom fitted | Th/wght bear nar m-l brim cu |
L2530 | 0010 | 3 | Addition to lower extremity, thigh-weight bearing, lacer, non-molded | Thigh/wght bear lacer non-mo |
L2540 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, lacer, molded to patient model | Thigh/wght bear lacer molded |
L2550 | 0010 | 3 | Addition to lower extremity, thigh/weight bearing, high roll cuff | Thigh/wght bear high roll cu |
L2570 | 0010 | 3 | Addition to lower extremity, pelvic control, hip joint, clevis type two position joint, each | Hip clevis type 2 posit jnt |
L2580 | 0010 | 3 | Addition to lower extremity, pelvic control, pelvic sling | Pelvic control pelvic sling |
L2600 | 0010 | 3 | Addition to lower extremity, pelvic control, hip joint, clevis type, or thrust bearing, free, each | Hip clevis/thrust bearing fr |
L2610 | 0010 | 3 | Addition to lower extremity, pelvic control, hip joint, clevis or thrust bearing, lock, each | Hip clevis/thrust bearing lo |
L2620 | 0010 | 3 | Addition to lower extremity, pelvic control, hip joint, heavy duty, each | Pelvic control hip heavy dut |
L2622 | 0010 | 3 | Addition to lower extremity, pelvic control, hip joint, adjustable flexion, each | Hip joint adjustable flexion |
L2624 | 0010 | 3 | Addition to lower extremity, pelvic control, hip joint, adjustable flexion, extension, abduction control, each | Hip adj flex ext abduct cont |
L2627 | 0010 | 3 | Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables | Plastic mold recipro hip & c |
L2628 | 0010 | 3 | Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables | Metal frame recipro hip & ca |
L2630 | 0010 | 3 | Addition to lower extremity, pelvic control, band and belt, unilateral | Pelvic control band & belt u |
L2640 | 0010 | 3 | Addition to lower extremity, pelvic control, band and belt, bilateral | Pelvic control band & belt b |
L2650 | 0010 | 3 | Addition to lower extremity, pelvic and thoracic control, gluteal pad, each | Pelv & thor control gluteal |
L2660 | 0010 | 3 | Addition to lower extremity, thoracic control, thoracic band | Thoracic control thoracic ba |
L2670 | 0010 | 3 | Addition to lower extremity, thoracic control, paraspinal uprights | Thorac cont paraspinal uprig |
L2680 | 0010 | 3 | Addition to lower extremity, thoracic control, lateral support uprights | Thorac cont lat support upri |
L2750 | 0010 | 3 | Addition to lower extremity orthosis, plating chrome or nickel, per bar | Plating chrome/nickel pr bar |
L2755 | 0010 | 3 | Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only | Carbon graphite lamination |
L2760 | 0010 | 3 | Addition to lower extremity orthosis, extension, per extension, per bar (for lineal adjustment for growth) | Extension per extension per |
L2768 | 0010 | 3 | Orthotic side bar disconnect device, per bar | Ortho sidebar disconnect |
L2780 | 0010 | 3 | Addition to lower extremity orthosis, non-corrosive finish, per bar | Non-corrosive finish |
L2785 | 0010 | 3 | Addition to lower extremity orthosis, drop lock retainer, each | Drop lock retainer each |
L2795 | 0010 | 3 | Addition to lower extremity orthosis, knee control, full kneecap | Knee control full kneecap |
L2800 | 0010 | 3 | Addition to lower extremity orthosis, knee control, knee cap, medial or lateral pull, for use with custom fabricated orthosis only | Knee cap medial or lateral p |
L2810 | 0010 | 3 | Addition to lower extremity orthosis, knee control, condylar pad | Knee control condylar pad |
L2820 | 0010 | 3 | Addition to lower extremity orthosis, soft interface for molded plastic, below knee section | Soft interface below knee se |
L2830 | 0010 | 3 | Addition to lower extremity orthosis, soft interface for molded plastic, above knee section | Soft interface above knee se |
L2840 | 0010 | 3 | Addition to lower extremity orthosis, tibial length sock, fracture or equal, each | Tibial length sock fx or equ |
L2850 | 0010 | 3 | Addition to lower extremity orthosis, femoral length sock, fracture or equal, each | Femoral lgth sock fx or equa |
L2861 | 0010 | 3 | Addition to lower extremity joint, knee or ankle, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each | Torsion mechanism knee/ankle |
L2999 | 0010 | 3 | Lower extremity orthoses, not otherwise specified | Lower extremity orthosis nos |
L3000 | 0010 | 3 | Foot, insert, removable, molded to patient model, ‘ucb’ type, berkeley shell, each | Ft insert ucb berkeley shell |
L3001 | 0010 | 3 | Foot, insert, removable, molded to patient model, spenco, each | Foot insert remov molded spe |
L3002 | 0010 | 3 | Foot, insert, removable, molded to patient model, plastazote or equal, each | Foot insert plastazote or eq |
L3003 | 0010 | 3 | Foot, insert, removable, molded to patient model, silicone gel, each | Foot insert silicone gel eac |
L3010 | 0010 | 3 | Foot, insert, removable, molded to patient model, longitudinal arch support, each | Foot longitudinal arch suppo |
L3020 | 0010 | 3 | Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each | Foot longitud/metatarsal sup |
L3030 | 0010 | 3 | Foot, insert, removable, formed to patient foot, each | Foot arch support remov prem |
L3031 | 0010 | 3 | Foot, insert/plate, removable, addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, each | Foot lamin/prepreg composite |
L3040 | 0010 | 3 | Foot, arch support, removable, premolded, longitudinal, each | Ft arch suprt premold longit |
L3050 | 0010 | 3 | Foot, arch support, removable, premolded, metatarsal, each | Foot arch supp premold metat |
L3060 | 0010 | 3 | Foot, arch support, removable, premolded, longitudinal/ metatarsal, each | Foot arch supp longitud/meta |
L3070 | 0010 | 3 | Foot, arch support, non-removable attached to shoe, longitudinal, each | Arch suprt att to sho longit |
L3080 | 0010 | 3 | Foot, arch support, non-removable attached to shoe, metatarsal, each | Arch supp att to shoe metata |
L3090 | 0010 | 3 | Foot, arch support, non-removable attached to shoe, longitudinal/metatarsal, each | Arch supp att to shoe long/m |
L3100 | 0010 | 3 | Hallus-valgus night dynamic splint, prefabricated, off-the-shelf | Hallus-valgus nt dyn pre ots |
L3140 | 0010 | 3 | Foot, abduction rotation bar, including shoes | Abduction rotation bar shoe |
L3150 | 0010 | 3 | Foot, abduction rotation bar, without shoes | Abduct rotation bar w/o shoe |
L3160 | 0010 | 3 | Foot, adjustable shoe-styled positioning device | Shoe styled positioning dev |
L3170 | 0010 | 3 | Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each | Foot plas heel stabi pre ots |
L3201 | 0010 | 3 | Orthopedic shoe, oxford with supinator or pronator, infant | Oxford w supinat/pronat inf |
L3202 | 0010 | 3 | Orthopedic shoe, oxford with supinator or pronator, child | Oxford w/ supinat/pronator c |
L3203 | 0010 | 3 | Orthopedic shoe, oxford with supinator or pronator, junior | Oxford w/ supinator/pronator |
L3204 | 0010 | 3 | Orthopedic shoe, hightop with supinator or pronator, infant | Hightop w/ supp/pronator inf |
L3206 | 0010 | 3 | Orthopedic shoe, hightop with supinator or pronator, child | Hightop w/ supp/pronator chi |
L3207 | 0010 | 3 | Orthopedic shoe, hightop with supinator or pronator, junior | Hightop w/ supp/pronator jun |
L3208 | 0010 | 3 | Surgical boot, each, infant | Surgical boot each infant |
L3209 | 0010 | 3 | Surgical boot, each, child | Surgical boot each child |
L3211 | 0010 | 3 | Surgical boot, each, junior | Surgical boot each junior |
L3212 | 0010 | 3 | Benesch boot, pair, infant | Benesch boot pair infant |
L3213 | 0010 | 3 | Benesch boot, pair, child | Benesch boot pair child |
L3214 | 0010 | 3 | Benesch boot, pair, junior | Benesch boot pair junior |
L3215 | 0010 | 3 | Orthopedic footwear, ladies shoe, oxford, each | Orthopedic ftwear ladies oxf |
L3216 | 0010 | 3 | Orthopedic footwear, ladies shoe, depth inlay, each | Orthoped ladies shoes dpth i |
L3217 | 0010 | 3 | Orthopedic footwear, ladies shoe, hightop, depth inlay, each | Ladies shoes hightop depth i |
L3219 | 0010 | 3 | Orthopedic footwear, mens shoe, oxford, each | Orthopedic mens shoes oxford |
L3221 | 0010 | 3 | Orthopedic footwear, mens shoe, depth inlay, each | Orthopedic mens shoes dpth i |
L3222 | 0010 | 3 | Orthopedic footwear, mens shoe, hightop, depth inlay, each | Mens shoes hightop depth inl |
L3224 | 0010 | 3 | Orthopedic footwear, woman’s shoe, oxford, used as an integral part of a brace (orthosis) | Woman’s shoe oxford brace |
L3225 | 0010 | 3 | Orthopedic footwear, man’s shoe, oxford, used as an integral part of a brace (orthosis) | Man’s shoe oxford brace |
L3230 | 0010 | 3 | Orthopedic footwear, custom shoe, depth inlay, each | Custom shoes depth inlay |
L3250 | 0010 | 3 | Orthopedic footwear, custom molded shoe, removable inner mold, prosthetic shoe, each | Custom mold shoe remov prost |
L3251 | 0010 | 3 | Foot, shoe molded to patient model, silicone shoe, each | Shoe molded to pt silicone s |
L3252 | 0010 | 3 | Foot, shoe molded to patient model, plastazote (or similar), custom fabricated, each | Shoe molded plastazote cust |
L3253 | 0010 | 3 | Foot, molded shoe plastazote (or similar) custom fitted, each | Shoe molded plastazote cust |
L3254 | 0010 | 3 | Non-standard size or width | Orth foot non-stndard size/w |
L3255 | 0010 | 3 | Non-standard size or length | Orth foot non-standard size/ |
L3257 | 0010 | 3 | Orthopedic footwear, additional charge for split size | Orth foot add charge split s |
L3260 | 0010 | 3 | Surgical boot/shoe, each | Ambulatory surgical boot eac |
L3265 | 0010 | 3 | Plastazote sandal, each | Plastazote sandal each |
L3300 | 0010 | 3 | Lift, elevation, heel, tapered to metatarsals, per inch | Sho lift taper to metatarsal |
L3310 | 0010 | 3 | Lift, elevation, heel and sole, neoprene, per inch | Shoe lift elev heel/sole neo |
L3320 | 0010 | 3 | Lift, elevation, heel and sole, cork, per inch | Shoe lift elev heel/sole cor |
L3330 | 0010 | 3 | Lift, elevation, metal extension (skate) | Lifts elevation metal extens |
L3332 | 0010 | 3 | Lift, elevation, inside shoe, tapered, up to one-half inch | Shoe lifts tapered to one-ha |
L3334 | 0010 | 3 | Lift, elevation, heel, per inch | Shoe lifts elevation heel /i |
L3340 | 0010 | 3 | Heel wedge, sach | Shoe wedge sach |
L3350 | 0010 | 3 | Heel wedge | Shoe heel wedge |
L3360 | 0010 | 3 | Sole wedge, outside sole | Shoe sole wedge outside sole |
L3370 | 0010 | 3 | Sole wedge, between sole | Shoe sole wedge between sole |
L3380 | 0010 | 3 | Clubfoot wedge | Shoe clubfoot wedge |
L3390 | 0010 | 3 | Outflare wedge | Shoe outflare wedge |
L3400 | 0010 | 3 | Metatarsal bar wedge, rocker | Shoe metatarsal bar wedge ro |
L3410 | 0010 | 3 | Metatarsal bar wedge, between sole | Shoe metatarsal bar between |
L3420 | 0010 | 3 | Full sole and heel wedge, between sole | Full sole/heel wedge btween |
L3430 | 0010 | 3 | Heel, counter, plastic reinforced | Sho heel count plast reinfor |
L3440 | 0010 | 3 | Heel, counter, leather reinforced | Heel leather reinforced |
L3450 | 0010 | 3 | Heel, sach cushion type | Shoe heel sach cushion type |
L3455 | 0010 | 3 | Heel, new leather, standard | Shoe heel new leather standa |
L3460 | 0010 | 3 | Heel, new rubber, standard | Shoe heel new rubber standar |
L3465 | 0010 | 3 | Heel, thomas with wedge | Shoe heel thomas with wedge |
L3470 | 0010 | 3 | Heel, thomas extended to ball | Shoe heel thomas extend to b |
L3480 | 0010 | 3 | Heel, pad and depression for spur | Shoe heel pad & depress for |
L3485 | 0010 | 3 | Heel, pad, removable for spur | Shoe heel pad removable for |
L3500 | 0010 | 3 | Orthopedic shoe addition, insole, leather | Ortho shoe add leather insol |
L3510 | 0010 | 3 | Orthopedic shoe addition, insole, rubber | Orthopedic shoe add rub insl |
L3520 | 0010 | 3 | Orthopedic shoe addition, insole, felt covered with leather | O shoe add felt w leath insl |
L3530 | 0010 | 3 | Orthopedic shoe addition, sole, half | Ortho shoe add half sole |
L3540 | 0010 | 3 | Orthopedic shoe addition, sole, full | Ortho shoe add full sole |
L3550 | 0010 | 3 | Orthopedic shoe addition, toe tap standard | O shoe add standard toe tap |
L3560 | 0010 | 3 | Orthopedic shoe addition, toe tap, horseshoe | O shoe add horseshoe toe tap |
L3570 | 0010 | 3 | Orthopedic shoe addition, special extension to instep (leather with eyelets) | O shoe add instep extension |
L3580 | 0010 | 3 | Orthopedic shoe addition, convert instep to velcro closure | O shoe add instep velcro clo |
L3590 | 0010 | 3 | Orthopedic shoe addition, convert firm shoe counter to soft counter | O shoe convert to sof counte |
L3595 | 0010 | 3 | Orthopedic shoe addition, march bar | Ortho shoe add march bar |
L3600 | 0010 | 3 | Transfer of an orthosis from one shoe to another, caliper plate, existing | Trans shoe calip plate exist |
L3610 | 0010 | 3 | Transfer of an orthosis from one shoe to another, caliper plate, new | Trans shoe caliper plate new |
L3620 | 0010 | 3 | Transfer of an orthosis from one shoe to another, solid stirrup, existing | Trans shoe solid stirrup exi |
L3630 | 0010 | 3 | Transfer of an orthosis from one shoe to another, solid stirrup, new | Trans shoe solid stirrup new |
L3640 | 0010 | 3 | Transfer of an orthosis from one shoe to another, dennis browne splint (riveton), both shoes | Shoe dennis browne splint bo |
L3649 | 0010 | 3 | Orthopedic shoe, modification, addition or transfer, not otherwise specified | Orthopedic shoe modifica nos |
L3650 | 0010 | 3 | Shoulder orthosis, figure of eight design abduction restrainer, prefabricated, off-the-shelf | So 8 abd restraint pre ots |
L3660 | 0010 | 3 | Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf | So 8 ab rstr can/web pre ots |
L3670 | 0010 | 3 | Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf | So acro/clav can web pre ots |
L3671 | 0010 | 3 | Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | So cap design w/o jnts cf |
L3674 | 0010 | 3 | 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 | So airplane w/wo joint cf |
L3675 | 0010 | 3 | Shoulder orthosis, vest type abduction restrainer, canvas webbing type or equal, prefabricated, off-the-shelf | So vest canvas/web pre ots |
L3677 | 0010 | 3 | 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 | So hard plas stabili pre cst |
L3678 | 0010 | 3 | Shoulder orthosis, shoulder joint design, without joints, may include soft interface, straps, prefabricated, off-the-shelf | So hard plas stabili pre ots |
L3702 | 0010 | 3 | Elbow orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Eo w/o joints cf |
L3710 | 0010 | 3 | Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf | Eo elas w/metal jnts pre ots |
L3720 | 0010 | 3 | Elbow orthosis, double upright with forearm/arm cuffs, free motion, custom fabricated | Forearm/arm cuffs free motio |
L3730 | 0010 | 3 | Elbow orthosis, double upright with forearm/arm cuffs, extension/ flexion assist, custom fabricated | Forearm/arm cuffs ext/flex a |
L3740 | 0010 | 3 | Elbow orthosis, double upright with forearm/arm cuffs, adjustable position lock with active control, custom fabricated | Cuffs adj lock w/ active con |
L3760 | 0010 | 3 | 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 | Eo adj jt prefab custom fit |
L3761 | 0010 | 3 | Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf | Eo, adj lock joint prefab ot |
L3762 | 0010 | 3 | Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf | Eo rigid w/o joints pre ots |
L3763 | 0010 | 3 | Elbow wrist hand orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Ewho rigid w/o jnts cf |
L3764 | 0010 | 3 | Elbow wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Ewho w/joint(s) cf |
L3765 | 0010 | 3 | Elbow wrist hand finger orthosis, rigid, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Ewhfo rigid w/o jnts cf |
L3766 | 0010 | 3 | 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 | Ewhfo w/joint(s) cf |
L3806 | 0010 | 3 | 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 | Whfo w/joint(s) custom fab |
L3807 | 0010 | 3 | 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 | Whfo w/o joints pre cst |
L3808 | 0010 | 3 | Wrist hand finger orthosis, rigid without joints, may include soft interface material; straps, custom fabricated, includes fitting and adjustment | Whfo, rigid w/o joints |
L3809 | 0010 | 3 | Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type | Whfo w/o joints pre ots |
L3891 | 0010 | 3 | Addition to upper extremity joint, wrist or elbow, concentric adjustable torsion style mechanism for custom fabricated orthotics only, each | Torsion mechanism wrist/elbo |
L3900 | 0010 | 3 | Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, wrist or finger driven, custom fabricated | Hinge extension/flex wrist/f |
L3901 | 0010 | 3 | Wrist hand finger orthosis, dynamic flexor hinge, reciprocal wrist extension/ flexion, finger flexion/extension, cable driven, custom fabricated | Hinge ext/flex wrist finger |
L3904 | 0010 | 3 | Wrist hand finger orthosis, external powered, electric, custom fabricated | Whfo electric custom fitted |
L3905 | 0010 | 3 | Wrist hand orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Who w/nontorsion jnt(s) cf |
L3906 | 0010 | 3 | Wrist hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Who w/o joints cf |
L3908 | 0010 | 3 | Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf | Who cock-up nonmolde pre ots |
L3912 | 0010 | 3 | Hand finger orthosis (hfo), flexion glove with elastic finger control, prefabricated, off-the-shelf | Hfo flexion glove pre ots |
L3913 | 0010 | 3 | Hand finger orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Hfo w/o joints cf |
L3915 | 0010 | 3 | 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 | Who nontorsion jnts pre cst |
L3916 | 0010 | 3 | Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf | Who nontorsion jnts pre ots |
L3917 | 0010 | 3 | 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 | Metacarp fx orthosis pre cst |
L3918 | 0010 | 3 | Hand orthosis, metacarpal fracture orthosis, prefabricated, off-the-shelf | Metacarp fx orthosis pre ots |
L3919 | 0010 | 3 | Hand orthosis, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Ho w/o joints cf |
L3921 | 0010 | 3 | Hand finger orthosis, includes one or more nontorsion joints, elastic bands, turnbuckles, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Hfo w/joint(s) cf |
L3923 | 0010 | 3 | 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 | Hfo without joints pre cst |
L3924 | 0010 | 3 | Hand finger orthosis, without joints, may include soft interface, straps, prefabricated, off-the-shelf | Hfo without joints pre ots |
L3925 | 0010 | 3 | Finger orthosis, proximal interphalangeal (pip)/distal interphalangeal (dip), non torsion joint/spring, extension/flexion, may include soft interface material, prefabricated, off-the-shelf | Fo pip dip jnt/sprng pre ots |
L3927 | 0010 | 3 | 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 | Fo pip dip no jt spr pre ots |
L3929 | 0010 | 3 | 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 | Hfo nontorsion jnts pre cst |
L3930 | 0010 | 3 | Hand finger orthosis, includes one or more nontorsion joint(s), turnbuckles, elastic bands/springs, may include soft interface material, straps, prefabricated, off-the-shelf | Hfo nontorsion jnts pre ots |
L3931 | 0010 | 3 | 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 | Whfo nontorsion joint prefab |
L3933 | 0010 | 3 | Finger orthosis, without joints, may include soft interface, custom fabricated, includes fitting and adjustment | Fo w/o joints cf |
L3935 | 0010 | 3 | Finger orthosis, nontorsion joint, may include soft interface, custom fabricated, includes fitting and adjustment | Fo nontorsion joint cf |
L3956 | 0010 | 3 | Addition of joint to upper extremity orthosis, any material; per joint | Add joint upper ext orthosis |
L3960 | 0010 | 3 | Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment | Sewho airplan desig abdu pos |
L3961 | 0010 | 3 | Shoulder elbow wrist hand orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Sewho cap design w/o jnts cf |
L3962 | 0010 | 3 | Shoulder elbow wrist hand orthosis, abduction positioning, erb’s palsey design, prefabricated, includes fitting and adjustment | Sewho erbs palsey design abd |
L3967 | 0010 | 3 | 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 | Sewho airplane w/o jnts cf |
L3971 | 0010 | 3 | 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 | Sewho cap design w/jnt(s) cf |
L3973 | 0010 | 3 | 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 | Sewho airplane w/jnt(s) cf |
L3975 | 0010 | 3 | Shoulder elbow wrist hand finger orthosis, shoulder cap design, without joints, may include soft interface, straps, custom fabricated, includes fitting and adjustment | Sewhfo cap design w/o jnt cf |
L3976 | 0010 | 3 | 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 | Sewhfo airplane w/o jnts cf |
L3977 | 0010 | 3 | 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 | Sewhfo cap desgn w/jnt(s) cf |
L3978 | 0010 | 3 | 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 | Sewhfo airplane w/jnt(s) cf |
L3980 | 0010 | 3 | Upper extremity fracture orthosis, humeral, prefabricated, includes fitting and adjustment | Up ext fx orthos humeral nos |
L3981 | 0010 | 3 | 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 | Ue fx orth shoul cap forearm |
L3982 | 0010 | 3 | Upper extremity fracture orthosis, radius/ulnar, prefabricated, includes fitting and adjustment | Upper ext fx orthosis rad/ul |
L3984 | 0010 | 3 | Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment | Upper ext fx orthosis wrist |
L3995 | 0010 | 3 | Addition to upper extremity orthosis, sock, fracture or equal, each | Sock fracture or equal each |
L3999 | 0010 | 3 | Upper limb orthosis, not otherwise specified | Upper limb orthosis nos |
L4000 | 0010 | 3 | Replace girdle for spinal orthosis (ctlso or so) | Repl girdle milwaukee orth |
L4002 | 0010 | 3 | Replacement strap, any orthosis, includes all components, any length, any type | Replace strap, any orthosis |
L4010 | 0010 | 3 | Replace trilateral socket brim | Replace trilateral socket br |
L4020 | 0010 | 3 | Replace quadrilateral socket brim, molded to patient model | Replace quadlat socket brim |
L4030 | 0010 | 3 | Replace quadrilateral socket brim, custom fitted | Replace socket brim cust fit |
L4040 | 0010 | 3 | Replace molded thigh lacer, for custom fabricated orthosis only | Replace molded thigh lacer |
L4045 | 0010 | 3 | Replace non-molded thigh lacer, for custom fabricated orthosis only | Replace non-molded thigh lac |
L4050 | 0010 | 3 | Replace molded calf lacer, for custom fabricated orthosis only | Replace molded calf lacer |
L4055 | 0010 | 3 | Replace non-molded calf lacer, for custom fabricated orthosis only | Replace non-molded calf lace |
L4060 | 0010 | 3 | Replace high roll cuff | Replace high roll cuff |
L4070 | 0010 | 3 | Replace proximal and distal upright for kafo | Replace prox & dist upright |
L4080 | 0010 | 3 | Replace metal bands kafo, proximal thigh | Repl met band kafo-afo prox |
L4090 | 0010 | 3 | Replace metal bands kafo-afo, calf or distal thigh | Repl met band kafo-afo calf/ |
L4100 | 0010 | 3 | Replace leather cuff kafo, proximal thigh | Repl leath cuff kafo prox th |
L4110 | 0010 | 3 | Replace leather cuff kafo-afo, calf or distal thigh | Repl leath cuff kafo-afo cal |
L4130 | 0010 | 3 | Replace pretibial shell | Replace pretibial shell |
L4205 | 0010 | 3 | Repair of orthotic device, labor component, per 15 minutes | Ortho dvc repair per 15 min |
L4210 | 0010 | 3 | Repair of orthotic device, repair or replace minor parts | Orth dev repair/repl minor p |
L4350 | 0010 | 3 | Ankle control orthosis, stirrup style, rigid, includes any type interface (e.g., pneumatic, gel), prefabricated, off-the-shelf | Ankle control ortho pre ots |
L4360 | 0010 | 3 | 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 | Pneumat walking boot pre cst |
L4361 | 0010 | 3 | Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf | Pneuma/vac walk boot pre ots |
L4370 | 0010 | 3 | Pneumatic full leg splint, prefabricated, off-the-shelf | Pneum full leg splnt pre ots |
L4386 | 0010 | 3 | 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 | Non-pneum walk boot pre cst |
L4387 | 0010 | 3 | Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf | Non-pneum walk boot pre ots |
L4392 | 0010 | 3 | Replacement, soft interface material, static afo | Replace afo soft interface |
L4394 | 0010 | 3 | Replace soft interface material, foot drop splint | Replace foot drop spint |
L4396 | 0010 | 3 | 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 | Static or dynami afo pre cst |
L4397 | 0010 | 3 | 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 | Static or dynami afo pre ots |
L4398 | 0010 | 3 | Foot drop splint, recumbent positioning device, prefabricated, off-the-shelf | Foot drop splint pre ots |
L4631 | 0010 | 3 | 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 | Afo, walk boot type, cus fab |
L5000 | 0010 | 3 | Partial foot, shoe insert with longitudinal arch, toe filler | Sho insert w arch toe filler |
L5010 | 0010 | 3 | Partial foot, molded socket, ankle height, with toe filler | Mold socket ank hgt w/ toe f |
L5020 | 0010 | 3 | Partial foot, molded socket, tibial tubercle height, with toe filler | Tibial tubercle hgt w/ toe f |
L5050 | 0010 | 3 | Ankle, symes, molded socket, sach foot | Ank symes mold sckt sach ft |
L5060 | 0010 | 3 | Ankle, symes, metal frame, molded leather socket, articulated ankle/foot | Symes met fr leath socket ar |
L5100 | 0010 | 3 | Below knee, molded socket, shin, sach foot | Molded socket shin sach foot |
L5105 | 0010 | 3 | Below knee, plastic socket, joints and thigh lacer, sach foot | Plast socket jts/thgh lacer |
L5150 | 0010 | 3 | Knee disarticulation (or through knee), molded socket, external knee joints, shin, sach foot | Mold sckt ext knee shin sach |
L5160 | 0010 | 3 | Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, sach foot | Mold socket bent knee shin s |
L5200 | 0010 | 3 | Above knee, molded socket, single axis constant friction knee, shin, sach foot | Kne sing axis fric shin sach |
L5210 | 0010 | 3 | Above knee, short prosthesis, no knee joint (‘stubbies’), with foot blocks, no ankle joints, each | No knee/ankle joints w/ ft b |
L5220 | 0010 | 3 | Above knee, short prosthesis, no knee joint (‘stubbies’), with articulated ankle/foot, dynamically aligned, each | No knee joint with artic ali |
L5230 | 0010 | 3 | Above knee, for proximal femoral focal deficiency, constant friction knee, shin, sach foot | Fem focal defic constant fri |
L5250 | 0010 | 3 | Hip disarticulation, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot | Hip canad sing axi cons fric |
L5270 | 0010 | 3 | Hip disarticulation, tilt table type; molded socket, locking hip joint, single axis constant friction knee, shin, sach foot | Tilt table locking hip sing |
L5280 | 0010 | 3 | Hemipelvectomy, canadian type; molded socket, hip joint, single axis constant friction knee, shin, sach foot | Hemipelvect canad sing axis |
L5301 | 0010 | 3 | Below knee, molded socket, shin, sach foot, endoskeletal system | Bk mold socket sach ft endo |
L5312 | 0010 | 3 | Knee disarticulation (or through knee), molded socket, single axis knee, pylon, sach foot, endoskeletal system | Knee disart, sach ft, endo |
L5321 | 0010 | 3 | Above knee, molded socket, open end, sach foot, endoskeletal system, single axis knee | Ak open end sach |
L5331 | 0010 | 3 | Hip disarticulation, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot | Hip disart canadian sach ft |
L5341 | 0010 | 3 | Hemipelvectomy, canadian type, molded socket, endoskeletal system, hip joint, single axis knee, sach foot | Hemipelvectomy canadian sach |
L5400 | 0010 | 3 | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment, suspension, and one cast change, below knee | Postop dress & 1 cast chg bk |
L5410 | 0010 | 3 | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension, below knee, each additional cast change and realignment | Postop dsg bk ea add cast ch |
L5420 | 0010 | 3 | Immediate post surgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change ‘ak’ or knee disarticulation | Postop dsg & 1 cast chg ak/d |
L5430 | 0010 | 3 | 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 | Postop dsg ak ea add cast ch |
L5450 | 0010 | 3 | Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, below knee | Postop app non-wgt bear dsg |
L5460 | 0010 | 3 | Immediate post surgical or early fitting, application of non-weight bearing rigid dressing, above knee | Postop app non-wgt bear dsg |
L5500 | 0010 | 3 | Initial, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed | Init bk ptb plaster direct |
L5505 | 0010 | 3 | Initial, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, direct formed | Init ak ischal plstr direct |
L5510 | 0010 | 3 | Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model | Prep bk ptb plaster molded |
L5520 | 0010 | 3 | Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed | Perp bk ptb thermopls direct |
L5530 | 0010 | 3 | Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model | Prep bk ptb thermopls molded |
L5535 | 0010 | 3 | Preparatory, below knee ‘ptb’ type socket, non-alignable system, no cover, sach foot, prefabricated, adjustable open end socket | Prep bk ptb open end socket |
L5540 | 0010 | 3 | Preparatory, below knee ‘ptb’ type socket, non-alignable system, pylon, no cover, sach foot, laminated socket, molded to model | Prep bk ptb laminated socket |
L5560 | 0010 | 3 | Preparatory, above knee- knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, plaster socket, molded to model | Prep ak ischial plast molded |
L5570 | 0010 | 3 | Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, direct formed | Prep ak ischial direct form |
L5580 | 0010 | 3 | Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon, no cover, sach foot, thermoplastic or equal, molded to model | Prep ak ischial thermo mold |
L5585 | 0010 | 3 | Preparatory, above knee - knee disarticulation, ischial level socket, non-alignable system, pylon, no cover, sach foot, prefabricated adjustable open end socket | Prep ak ischial open end |
L5590 | 0010 | 3 | Preparatory, above knee - knee disarticulation ischial level socket, non-alignable system, pylon no cover, sach foot, laminated socket, molded to model | Prep ak ischial laminated |
L5595 | 0010 | 3 | Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, thermoplastic or equal, molded to patient model | Hip disartic sach thermopls |
L5600 | 0010 | 3 | Preparatory, hip disarticulation-hemipelvectomy, pylon, no cover, sach foot, laminated socket, molded to patient model | Hip disart sach laminat mold |
L5610 | 0010 | 3 | Addition to lower extremity, endoskeletal system, above knee, hydracadence system | Above knee hydracadence |
L5611 | 0010 | 3 | Addition to lower extremity, endoskeletal system, above knee - knee disarticulation, 4 bar linkage, with friction swing phase control | Ak 4 bar link w/fric swing |
L5613 | 0010 | 3 | Addition to lower extremity, endoskeletal system, above knee-knee disarticulation, 4 bar linkage, with hydraulic swing phase control | Ak 4 bar ling w/hydraul swig |
L5614 | 0010 | 3 | Addition to lower extremity, exoskeletal system, above knee-knee disarticulation, 4 bar linkage, with pneumatic swing phase control | 4-bar link above knee w/swng |
L5616 | 0010 | 3 | Addition to lower extremity, endoskeletal system, above knee, universal multiplex system, friction swing phase control | Ak univ multiplex sys frict |
L5617 | 0010 | 3 | Addition to lower extremity, quick change self-aligning unit, above knee or below knee, each | Ak/bk self-aligning unit ea |
L5618 | 0010 | 3 | Addition to lower extremity, test socket, symes | Test socket symes |
L5620 | 0010 | 3 | Addition to lower extremity, test socket, below knee | Test socket below knee |
L5622 | 0010 | 3 | Addition to lower extremity, test socket, knee disarticulation | Test socket knee disarticula |
L5624 | 0010 | 3 | Addition to lower extremity, test socket, above knee | Test socket above knee |
L5626 | 0010 | 3 | Addition to lower extremity, test socket, hip disarticulation | Test socket hip disarticulat |
L5628 | 0010 | 3 | Addition to lower extremity, test socket, hemipelvectomy | Test socket hemipelvectomy |
L5629 | 0010 | 3 | Addition to lower extremity, below knee, acrylic socket | Below knee acrylic socket |
L5630 | 0010 | 3 | Addition to lower extremity, symes type, expandable wall socket | Syme typ expandabl wall sckt |
L5631 | 0010 | 3 | Addition to lower extremity, above knee or knee disarticulation, acrylic socket | Ak/knee disartic acrylic soc |
L5632 | 0010 | 3 | Addition to lower extremity, symes type, ‘ptb’ brim design socket | Symes type ptb brim design s |
L5634 | 0010 | 3 | Addition to lower extremity, symes type, posterior opening (canadian) socket | Symes type poster opening so |
L5636 | 0010 | 3 | Addition to lower extremity, symes type, medial opening socket | Symes type medial opening so |
L5637 | 0010 | 3 | Addition to lower extremity, below knee, total contact | Below knee total contact |
L5638 | 0010 | 3 | Addition to lower extremity, below knee, leather socket | Below knee leather socket |
L5639 | 0010 | 3 | Addition to lower extremity, below knee, wood socket | Below knee wood socket |
L5640 | 0010 | 3 | Addition to lower extremity, knee disarticulation, leather socket | Knee disarticulat leather so |
L5642 | 0010 | 3 | Addition to lower extremity, above knee, leather socket | Above knee leather socket |
L5643 | 0010 | 3 | Addition to lower extremity, hip disarticulation, flexible inner socket, external frame | Hip flex inner socket ext fr |
L5644 | 0010 | 3 | Addition to lower extremity, above knee, wood socket | Above knee wood socket |
L5645 | 0010 | 3 | Addition to lower extremity, below knee, flexible inner socket, external frame | Bk flex inner socket ext fra |
L5646 | 0010 | 3 | Addition to lower extremity, below knee, air, fluid, gel or equal, cushion socket | Below knee cushion socket |
L5647 | 0010 | 3 | Addition to lower extremity, below knee suction socket | Below knee suction socket |
L5648 | 0010 | 3 | Addition to lower extremity, above knee, air, fluid, gel or equal, cushion socket | Above knee cushion socket |
L5649 | 0010 | 3 | Addition to lower extremity, ischial containment/narrow m-l socket | Isch containmt/narrow m-l so |
L5650 | 0010 | 3 | Additions to lower extremity, total contact, above knee or knee disarticulation socket | Tot contact ak/knee disart s |
L5651 | 0010 | 3 | Addition to lower extremity, above knee, flexible inner socket, external frame | Ak flex inner socket ext fra |
L5652 | 0010 | 3 | Addition to lower extremity, suction suspension, above knee or knee disarticulation socket | Suction susp ak/knee disart |
L5653 | 0010 | 3 | Addition to lower extremity, knee disarticulation, expandable wall socket | Knee disart expand wall sock |
L5654 | 0010 | 3 | Addition to lower extremity, socket insert, symes, (kemblo, pelite, aliplast, plastazote or equal) | Socket insert symes |
L5655 | 0010 | 3 | Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal) | Socket insert below knee |
L5656 | 0010 | 3 | Addition to lower extremity, socket insert, knee disarticulation (kemblo, pelite, aliplast, plastazote or equal) | Socket insert knee articulat |
L5658 | 0010 | 3 | Addition to lower extremity, socket insert, above knee (kemblo, pelite, aliplast, plastazote or equal) | Socket insert above knee |
L5661 | 0010 | 3 | Addition to lower extremity, socket insert, multi-durometer symes | Multi-durometer symes |
L5665 | 0010 | 3 | Addition to lower extremity, socket insert, multi-durometer, below knee | Multi-durometer below knee |
L5666 | 0010 | 3 | Addition to lower extremity, below knee, cuff suspension | Below knee cuff suspension |
L5668 | 0010 | 3 | Addition to lower extremity, below knee, molded distal cushion | Bk molded distal cushion |
L5670 | 0010 | 3 | Addition to lower extremity, below knee, molded supracondylar suspension (‘pts’ or similar) | Bk molded supracondylar susp |
L5671 | 0010 | 3 | Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert | Bk/ak locking mechanism |
L5672 | 0010 | 3 | Addition to lower extremity, below knee, removable medial brim suspension | Bk removable medial brim sus |
L5673 | 0010 | 3 | Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, for use with locking mechanism | Socket insert w lock mech |
L5676 | 0010 | 3 | Additions to lower extremity, below knee, knee joints, single axis, pair | Bk knee joints single axis p |
L5677 | 0010 | 3 | Additions to lower extremity, below knee, knee joints, polycentric, pair | Bk knee joints polycentric p |
L5678 | 0010 | 3 | Additions to lower extremity, below knee, joint covers, pair | Bk joint covers pair |
L5679 | 0010 | 3 | Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric or equal, not for use with locking mechanism | Socket insert w/o lock mech |
L5680 | 0010 | 3 | Addition to lower extremity, below knee, thigh lacer, nonmolded | Bk thigh lacer non-molded |
L5681 | 0010 | 3 | 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) | Intl custm cong/latyp insert |
L5682 | 0010 | 3 | Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded | Bk thigh lacer glut/ischia m |
L5683 | 0010 | 3 | 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) | Initial custom socket insert |
L5684 | 0010 | 3 | Addition to lower extremity, below knee, fork strap | Bk fork strap |
L5685 | 0010 | 3 | Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each | Below knee sus/seal sleeve |
L5686 | 0010 | 3 | Addition to lower extremity, below knee, back check (extension control) | Bk back check |
L5688 | 0010 | 3 | Addition to lower extremity, below knee, waist belt, webbing | Bk waist belt webbing |
L5690 | 0010 | 3 | Addition to lower extremity, below knee, waist belt, padded and lined | Bk waist belt padded and lin |
L5692 | 0010 | 3 | Addition to lower extremity, above knee, pelvic control belt, light | Ak pelvic control belt light |
L5694 | 0010 | 3 | Addition to lower extremity, above knee, pelvic control belt, padded and lined | Ak pelvic control belt pad/l |
L5695 | 0010 | 3 | Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each | Ak sleeve susp neoprene/equa |
L5696 | 0010 | 3 | Addition to lower extremity, above knee or knee disarticulation, pelvic joint | Ak/knee disartic pelvic join |
L5697 | 0010 | 3 | Addition to lower extremity, above knee or knee disarticulation, pelvic band | Ak/knee disartic pelvic band |
L5698 | 0010 | 3 | Addition to lower extremity, above knee or knee disarticulation, silesian bandage | Ak/knee disartic silesian ba |
L5699 | 0010 | 3 | All lower extremity prostheses, shoulder harness | Shoulder harness |
L5700 | 0010 | 3 | Replacement, socket, below knee, molded to patient model | Replace socket below knee |
L5701 | 0010 | 3 | Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model | Replace socket above knee |
L5702 | 0010 | 3 | Replacement, socket, hip disarticulation, including hip joint, molded to patient model | Replace socket hip |
L5703 | 0010 | 3 | Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only | Symes ankle w/o (sach) foot |
L5704 | 0010 | 3 | Custom shaped protective cover, below knee | Custom shape cover bk |
L5705 | 0010 | 3 | Custom shaped protective cover, above knee | Custom shape cover ak |
L5706 | 0010 | 3 | Custom shaped protective cover, knee disarticulation | Custom shape cvr knee disart |
L5707 | 0010 | 3 | Custom shaped protective cover, hip disarticulation | Custom shape cvr hip disart |
L5710 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, manual lock | Kne-shin exo sng axi mnl loc |
L5711 | 0010 | 3 | Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material | Knee-shin exo mnl lock ultra |
L5712 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) | Knee-shin exo frict swg & st |
L5714 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control | Knee-shin exo variable frict |
L5716 | 0010 | 3 | Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock | Knee-shin exo mech stance ph |
L5718 | 0010 | 3 | Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control | Knee-shin exo frct swg & sta |
L5722 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control | Knee-shin pneum swg frct exo |
L5724 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, fluid swing phase control | Knee-shin exo fluid swing ph |
L5726 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control | Knee-shin ext jnts fld swg e |
L5728 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control | Knee-shin fluid swg & stance |
L5780 | 0010 | 3 | Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control | Knee-shin pneum/hydra pneum |
L5781 | 0010 | 3 | Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system | Lower limb pros vacuum pump |
L5782 | 0010 | 3 | Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy duty | Hd low limb pros vacuum pump |
L5785 | 0010 | 3 | Addition, exoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) | Exoskeletal bk ultralt mater |
L5790 | 0010 | 3 | Addition, exoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) | Exoskeletal ak ultra-light m |
L5795 | 0010 | 3 | Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) | Exoskel hip ultra-light mate |
L5810 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, manual lock | Endoskel knee-shin mnl lock |
L5811 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, manual lock, ultra-light material | Endo knee-shin mnl lck ultra |
L5812 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) | Endo knee-shin frct swg & st |
L5814 | 0010 | 3 | Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock | Endo knee-shin hydral swg ph |
L5816 | 0010 | 3 | Addition, endoskeletal knee-shin system, polycentric, mechanical stance phase lock | Endo knee-shin polyc mch sta |
L5818 | 0010 | 3 | Addition, endoskeletal knee-shin system, polycentric, friction swing, and stance phase control | Endo knee-shin frct swg & st |
L5822 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control | Endo knee-shin pneum swg frc |
L5824 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, fluid swing phase control | Endo knee-shin fluid swing p |
L5826 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, hydraulic swing phase control, with miniature high activity frame | Miniature knee joint |
L5828 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control | Endo knee-shin fluid swg/sta |
L5830 | 0010 | 3 | Addition, endoskeletal knee-shin system, single axis, pneumatic/ swing phase control | Endo knee-shin pneum/swg pha |
L5840 | 0010 | 3 | Addition, endoskeletal knee/shin system, 4-bar linkage or multiaxial, pneumatic swing phase control | Multi-axial knee/shin system |
L5845 | 0010 | 3 | Addition, endoskeletal, knee-shin system, stance flexion feature, adjustable | Knee-shin sys stance flexion |
L5848 | 0010 | 3 | Addition to endoskeletal knee-shin system, fluid stance extension, dampening feature, with or without adjustability | Knee-shin sys hydraul stance |
L5850 | 0010 | 3 | Addition, endoskeletal system, above knee or hip disarticulation, knee extension assist | Endo ak/hip knee extens assi |
L5855 | 0010 | 3 | Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist | Mech hip extension assist |
L5856 | 0010 | 3 | Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type | Elec knee-shin swing/stance |
L5857 | 0010 | 3 | Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing phase only, includes electronic sensor(s), any type | Elec knee-shin swing only |
L5858 | 0010 | 3 | Addition to lower extremity prosthesis, endoskeletal knee shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type | Stance phase only |
L5859 | 0010 | 3 | Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s) | Knee-shin pro flex/ext cont |
L5910 | 0010 | 3 | Addition, endoskeletal system, below knee, alignable system | Endo below knee alignable sy |
L5920 | 0010 | 3 | Addition, endoskeletal system, above knee or hip disarticulation, alignable system | Endo ak/hip alignable system |
L5925 | 0010 | 3 | Addition, endoskeletal system, above knee, knee disarticulation or hip disarticulation, manual lock | Above knee manual lock |
L5930 | 0010 | 3 | Addition, endoskeletal system, high activity knee control frame | High activity knee frame |
L5940 | 0010 | 3 | Addition, endoskeletal system, below knee, ultra-light material (titanium, carbon fiber or equal) | Endo bk ultra-light material |
L5950 | 0010 | 3 | Addition, endoskeletal system, above knee, ultra-light material (titanium, carbon fiber or equal) | Endo ak ultra-light material |
L5960 | 0010 | 3 | Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal) | Endo hip ultra-light materia |
L5961 | 0010 | 3 | Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control | Endo poly hip, pneu/hyd/rot |
L5962 | 0010 | 3 | Addition, endoskeletal system, below knee, flexible protective outer surface covering system | Below knee flex cover system |
L5964 | 0010 | 3 | Addition, endoskeletal system, above knee, flexible protective outer surface covering system | Above knee flex cover system |
L5966 | 0010 | 3 | Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system | Hip flexible cover system |
L5968 | 0010 | 3 | Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature | Multiaxial ankle w dorsiflex |
L5969 | 0010 | 3 | Addition, endoskeletal ankle-foot or ankle system, power assist, includes any type motor(s) | Ak/ft power asst incl motors |
L5970 | 0010 | 3 | All lower extremity prostheses, foot, external keel, sach foot | Foot external keel sach foot |
L5971 | 0010 | 3 | All lower extremity prosthesis, solid ankle cushion heel (sach) foot, replacement only | Sach foot, replacement |
L5972 | 0010 | 3 | All lower extremity prostheses, foot, flexible keel | Flexible keel foot |
L5973 | 0010 | 3 | Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source | Ank-foot sys dors-plant flex |
L5974 | 0010 | 3 | All lower extremity prostheses, foot, single axis ankle/foot | Foot single axis ankle/foot |
L5975 | 0010 | 3 | All lower extremity prosthesis, combination single axis ankle and flexible keel foot | Combo ankle/foot prosthesis |
L5976 | 0010 | 3 | All lower extremity prostheses, energy storing foot (seattle carbon copy ii or equal) | Energy storing foot |
L5978 | 0010 | 3 | All lower extremity prostheses, foot, multiaxial ankle/foot | Ft prosth multiaxial ankl/ft |
L5979 | 0010 | 3 | All lower extremity prosthesis, multi-axial ankle, dynamic response foot, one piece system | Multi-axial ankle/ft prosth |
L5980 | 0010 | 3 | All lower extremity prostheses, flex foot system | Flex foot system |
L5981 | 0010 | 3 | All lower extremity prostheses, flex-walk system or equal | Flex-walk sys low ext prosth |
L5982 | 0010 | 3 | All exoskeletal lower extremity prostheses, axial rotation unit | Exoskeletal axial rotation u |
L5984 | 0010 | 3 | All endoskeletal lower extremity prosthesis, axial rotation unit, with or without adjustability | Endoskeletal axial rotation |
L5985 | 0010 | 3 | All endoskeletal lower extremity prostheses, dynamic prosthetic pylon | Lwr ext dynamic prosth pylon |
L5986 | 0010 | 3 | All lower extremity prostheses, multi-axial rotation unit (‘mcp’ or equal) | Multi-axial rotation unit |
L5987 | 0010 | 3 | All lower extremity prosthesis, shank foot system with vertical loading pylon | Shank ft w vert load pylon |
L5988 | 0010 | 3 | Addition to lower limb prosthesis, vertical shock reducing pylon feature | Vertical shock reducing pylo |
L5990 | 0010 | 3 | Addition to lower extremity prosthesis, user adjustable heel height | User adjustable heel height |
L5999 | 0010 | 3 | Lower extremity prosthesis, not otherwise specified | Lowr extremity prosthes nos |
L6000 | 0010 | 3 | Partial hand, thumb remaining | Part hand thumb rem |
L6010 | 0010 | 3 | Partial hand, little and/or ring finger remaining | Part hand little/ring |
L6020 | 0010 | 3 | Partial hand, no finger remaining | Part hand no fingers |
L6025 | 0010 | 3 | 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 | Part hand disart myoelectric |
L6026 | 0010 | 3 | 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) | Part hand myo exclu term dev |
L6050 | 0010 | 3 | Wrist disarticulation, molded socket, flexible elbow hinges, triceps pad | Wrst mld sck flx hng tri pad |
L6055 | 0010 | 3 | Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad | Wrst mold sock w/exp interfa |
L6100 | 0010 | 3 | Below elbow, molded socket, flexible elbow hinge, triceps pad | Elb mold sock flex hinge pad |
L6110 | 0010 | 3 | Below elbow, molded socket, (muenster or northwestern suspension types) | Elbow mold sock suspension t |
L6120 | 0010 | 3 | Below elbow, molded double wall split socket, step-up hinges, half cuff | Elbow mold doub splt soc ste |
L6130 | 0010 | 3 | Below elbow, molded double wall split socket, stump activated locking hinge, half cuff | Elbow stump activated lock h |
L6200 | 0010 | 3 | Elbow disarticulation, molded socket, outside locking hinge, forearm | Elbow mold outsid lock hinge |
L6205 | 0010 | 3 | Elbow disarticulation, molded socket with expandable interface, outside locking hinges, forearm | Elbow molded w/ expand inter |
L6250 | 0010 | 3 | Above elbow, molded double wall socket, internal locking elbow, forearm | Elbow inter loc elbow forarm |
L6300 | 0010 | 3 | Shoulder disarticulation, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm | Shlder disart int lock elbow |
L6310 | 0010 | 3 | Shoulder disarticulation, passive restoration (complete prosthesis) | Shoulder passive restor comp |
L6320 | 0010 | 3 | Shoulder disarticulation, passive restoration (shoulder cap only) | Shoulder passive restor cap |
L6350 | 0010 | 3 | Interscapular thoracic, molded socket, shoulder bulkhead, humeral section, internal locking elbow, forearm | Thoracic intern lock elbow |
L6360 | 0010 | 3 | Interscapular thoracic, passive restoration (complete prosthesis) | Thoracic passive restor comp |
L6370 | 0010 | 3 | Interscapular thoracic, passive restoration (shoulder cap only) | Thoracic passive restor cap |
L6380 | 0010 | 3 | 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 | Postop dsg cast chg wrst/elb |
L6382 | 0010 | 3 | 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 | Postop dsg cast chg elb dis/ |
L6384 | 0010 | 3 | 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 | Postop dsg cast chg shlder/t |
L6386 | 0010 | 3 | Immediate post surgical or early fitting, each additional cast change and realignment | Postop ea cast chg & realign |
L6388 | 0010 | 3 | Immediate post surgical or early fitting, application of rigid dressing only | Postop applicat rigid dsg on |
L6400 | 0010 | 3 | Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping | Below elbow prosth tiss shap |
L6450 | 0010 | 3 | Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping | Elb disart prosth tiss shap |
L6500 | 0010 | 3 | Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping | Above elbow prosth tiss shap |
L6550 | 0010 | 3 | Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping | Shldr disar prosth tiss shap |
L6570 | 0010 | 3 | Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping | Scap thorac prosth tiss shap |
L6580 | 0010 | 3 | 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 | Wrist/elbow bowden cable mol |
L6582 | 0010 | 3 | 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 | Wrist/elbow bowden cbl dir f |
L6584 | 0010 | 3 | 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 | Elbow fair lead cable molded |
L6586 | 0010 | 3 | 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 | Elbow fair lead cable dir fo |
L6588 | 0010 | 3 | 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 | Shdr fair lead cable molded |
L6590 | 0010 | 3 | 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 | Shdr fair lead cable direct |
L6600 | 0010 | 3 | Upper extremity additions, polycentric hinge, pair | Polycentric hinge pair |
L6605 | 0010 | 3 | Upper extremity additions, single pivot hinge, pair | Single pivot hinge pair |
L6610 | 0010 | 3 | Upper extremity additions, flexible metal hinge, pair | Flexible metal hinge pair |
L6611 | 0010 | 3 | Addition to upper extremity prosthesis, external powered, additional switch, any type | Additional switch, ext power |
L6615 | 0010 | 3 | Upper extremity addition, disconnect locking wrist unit | Disconnect locking wrist uni |
L6616 | 0010 | 3 | Upper extremity addition, additional disconnect insert for locking wrist unit, each | Disconnect insert locking wr |
L6620 | 0010 | 3 | Upper extremity addition, flexion/extension wrist unit, with or without friction | Flexion/extension wrist unit |
L6621 | 0010 | 3 | Upper extremity prosthesis addition, flexion/extension wrist with or without friction, for use with external powered terminal device | Flex/ext wrist w/wo friction |
L6623 | 0010 | 3 | Upper extremity addition, spring assisted rotational wrist unit with latch release | Spring-ass rot wrst w/ latch |
L6624 | 0010 | 3 | Upper extremity addition, flexion/extension and rotation wrist unit | Flex/ext/rotation wrist unit |
L6625 | 0010 | 3 | Upper extremity addition, rotation wrist unit with cable lock | Rotation wrst w/ cable lock |
L6628 | 0010 | 3 | Upper extremity addition, quick disconnect hook adapter, otto bock or equal | Quick disconn hook adapter o |
L6629 | 0010 | 3 | Upper extremity addition, quick disconnect lamination collar with coupling piece, otto bock or equal | Lamination collar w/ couplin |
L6630 | 0010 | 3 | Upper extremity addition, stainless steel, any wrist | Stainless steel any wrist |
L6632 | 0010 | 3 | Upper extremity addition, latex suspension sleeve, each | Latex suspension sleeve each |
L6635 | 0010 | 3 | Upper extremity addition, lift assist for elbow | Lift assist for elbow |
L6637 | 0010 | 3 | Upper extremity addition, nudge control elbow lock | Nudge control elbow lock |
L6638 | 0010 | 3 | Upper extremity addition to prosthesis, electric locking feature, only for use with manually powered elbow | Elec lock on manual pw elbow |
L6640 | 0010 | 3 | Upper extremity additions, shoulder abduction joint, pair | Shoulder abduction joint pai |
L6641 | 0010 | 3 | Upper extremity addition, excursion amplifier, pulley type | Excursion amplifier pulley t |
L6642 | 0010 | 3 | Upper extremity addition, excursion amplifier, lever type | Excursion amplifier lever ty |
L6645 | 0010 | 3 | Upper extremity addition, shoulder flexion-abduction joint, each | Shoulder flexion-abduction j |
L6646 | 0010 | 3 | Upper extremity addition, shoulder joint, multipositional locking, flexion, adjustable abduction friction control, for use with body powered or external powered system | Multipo locking shoulder jnt |
L6647 | 0010 | 3 | Upper extremity addition, shoulder lock mechanism, body powered actuator | Shoulder lock actuator |
L6648 | 0010 | 3 | Upper extremity addition, shoulder lock mechanism, external powered actuator | Ext pwrd shlder lock/unlock |
L6650 | 0010 | 3 | Upper extremity addition, shoulder universal joint, each | Shoulder universal joint |
L6655 | 0010 | 3 | Upper extremity addition, standard control cable, extra | Standard control cable extra |
L6660 | 0010 | 3 | Upper extremity addition, heavy duty control cable | Heavy duty control cable |
L6665 | 0010 | 3 | Upper extremity addition, teflon, or equal, cable lining | Teflon or equal cable lining |
L6670 | 0010 | 3 | Upper extremity addition, hook to hand, cable adapter | Hook to hand cable adapter |
L6672 | 0010 | 3 | Upper extremity addition, harness, chest or shoulder, saddle type | Harness chest/shlder saddle |
L6675 | 0010 | 3 | Upper extremity addition, harness, (e.g., figure of eight type), single cable design | Harness figure of 8 sing con |
L6676 | 0010 | 3 | Upper extremity addition, harness, (e.g., figure of eight type), dual cable design | Harness figure of 8 dual con |
L6677 | 0010 | 3 | Upper extremity addition, harness, triple control, simultaneous operation of terminal device and elbow | Ue triple control harness |
L6680 | 0010 | 3 | Upper extremity addition, test socket, wrist disarticulation or below elbow | Test sock wrist disart/bel e |
L6682 | 0010 | 3 | Upper extremity addition, test socket, elbow disarticulation or above elbow | Test sock elbw disart/above |
L6684 | 0010 | 3 | Upper extremity addition, test socket, shoulder disarticulation or interscapular thoracic | Test socket shldr disart/tho |
L6686 | 0010 | 3 | Upper extremity addition, suction socket | Suction socket |
L6687 | 0010 | 3 | Upper extremity addition, frame type socket, below elbow or wrist disarticulation | Frame typ socket bel elbow/w |
L6688 | 0010 | 3 | Upper extremity addition, frame type socket, above elbow or elbow disarticulation | Frame typ sock above elb/dis |
L6689 | 0010 | 3 | Upper extremity addition, frame type socket, shoulder disarticulation | Frame typ socket shoulder di |
L6690 | 0010 | 3 | Upper extremity addition, frame type socket, interscapular-thoracic | Frame typ sock interscap-tho |
L6691 | 0010 | 3 | Upper extremity addition, removable insert, each | Removable insert each |
L6692 | 0010 | 3 | Upper extremity addition, silicone gel insert or equal, each | Silicone gel insert or equal |
L6693 | 0010 | 3 | Upper extremity addition, locking elbow, forearm counterbalance | Lockingelbow forearm cntrbal |
L6694 | 0010 | 3 | 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 | Elbow socket ins use w/lock |
L6695 | 0010 | 3 | 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 | Elbow socket ins use w/o lck |
L6696 | 0010 | 3 | 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) | Cus elbo skt in for con/atyp |
L6697 | 0010 | 3 | 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) | Cus elbo skt in not con/atyp |
L6698 | 0010 | 3 | Addition to upper extremity prosthesis, below elbow/above elbow, lock mechanism, excludes socket insert | Below/above elbow lock mech |
L6703 | 0010 | 3 | Terminal device, passive hand/mitt, any material, any size | Term dev, passive hand mitt |
L6704 | 0010 | 3 | Terminal device, sport/recreational/work attachment, any material, any size | Term dev, sport/rec/work att |
L6706 | 0010 | 3 | Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined | Term dev mech hook vol open |
L6707 | 0010 | 3 | Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined | Term dev mech hook vol close |
L6708 | 0010 | 3 | Terminal device, hand, mechanical, voluntary opening, any material, any size | Term dev mech hand vol open |
L6709 | 0010 | 3 | Terminal device, hand, mechanical, voluntary closing, any material, any size | Term dev mech hand vol close |
L6711 | 0010 | 3 | Terminal device, hook, mechanical, voluntary opening, any material, any size, lined or unlined, pediatric | Ped term dev, hook, vol open |
L6712 | 0010 | 3 | Terminal device, hook, mechanical, voluntary closing, any material, any size, lined or unlined, pediatric | Ped term dev, hook, vol clos |
L6713 | 0010 | 3 | Terminal device, hand, mechanical, voluntary opening, any material, any size, pediatric | Ped term dev, hand, vol open |
L6714 | 0010 | 3 | Terminal device, hand, mechanical, voluntary closing, any material, any size, pediatric | Ped term dev, hand, vol clos |
L6715 | 0010 | 3 | Terminal device, multiple articulating digit, includes motor(s), initial issue or replacement | Term device, multi art digit |
L6721 | 0010 | 3 | Terminal device, hook or hand, heavy duty, mechanical, voluntary opening, any material, any size, lined or unlined | Hook/hand, hvy dty, vol open |
L6722 | 0010 | 3 | Terminal device, hook or hand, heavy duty, mechanical, voluntary closing, any material, any size, lined or unlined | Hook/hand, hvy dty, vol clos |
L6805 | 0010 | 3 | Addition to terminal device, modifier wrist unit | Term dev modifier wrist unit |
L6810 | 0010 | 3 | Addition to terminal device, precision pinch device | Term dev precision pinch dev |
L6880 | 0010 | 3 | Electric hand, switch or myoelectric controlled, independently articulating digits, any grasp pattern or combination of grasp patterns, includes motor(s) | Elec hand ind art digits |
L6881 | 0010 | 3 | Automatic grasp feature, addition to upper limb electric prosthetic terminal device | Term dev auto grasp feature |
L6882 | 0010 | 3 | Microprocessor control feature, addition to upper limb prosthetic terminal device | Microprocessor control uplmb |
L6883 | 0010 | 3 | Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power | Replc sockt below e/w disa |
L6884 | 0010 | 3 | Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power | Replc sockt above elbow disa |
L6885 | 0010 | 3 | Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power | Replc sockt shldr dis/interc |
L6890 | 0010 | 3 | Addition to upper extremity prosthesis, glove for terminal device, any material, prefabricated, includes fitting and adjustment | Prefab glove for term device |
L6895 | 0010 | 3 | Addition to upper extremity prosthesis, glove for terminal device, any material, custom fabricated | Custom glove for term device |
L6900 | 0010 | 3 | Hand restoration (casts, shading and measurements included), partial hand, with glove, thumb or one finger remaining | Hand restorat thumb/1 finger |
L6905 | 0010 | 3 | Hand restoration (casts, shading and measurements included), partial hand, with glove, multiple fingers remaining | Hand restoration multiple fi |
L6910 | 0010 | 3 | Hand restoration (casts, shading and measurements included), partial hand, with glove, no fingers remaining | Hand restoration no fingers |
L6915 | 0010 | 3 | Hand restoration (shading, and measurements included), replacement glove for above | Hand restoration replacmnt g |
L6920 | 0010 | 3 | 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 | Wrist disarticul switch ctrl |
L6925 | 0010 | 3 | 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 | Wrist disart myoelectronic c |
L6930 | 0010 | 3 | 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 | Below elbow switch control |
L6935 | 0010 | 3 | 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 | Below elbow myoelectronic ct |
L6940 | 0010 | 3 | 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 | Elbow disarticulation switch |
L6945 | 0010 | 3 | 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 | Elbow disart myoelectronic c |
L6950 | 0010 | 3 | 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 | Above elbow switch control |
L6955 | 0010 | 3 | 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 | Above elbow myoelectronic ct |
L6960 | 0010 | 3 | 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 | Shldr disartic switch contro |
L6965 | 0010 | 3 | 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 | Shldr disartic myoelectronic |
L6970 | 0010 | 3 | 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 | Interscapular-thor switch ct |
L6975 | 0010 | 3 | 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 | Interscap-thor myoelectronic |
L7007 | 0010 | 3 | Electric hand, switch or myoelectric controlled, adult | Adult electric hand |
L7008 | 0010 | 3 | Electric hand, switch or myoelectric, controlled, pediatric | Pediatric electric hand |
L7009 | 0010 | 3 | Electric hook, switch or myoelectric controlled, adult | Adult electric hook |
L7040 | 0010 | 3 | Prehensile actuator, switch controlled | Prehensile actuator |
L7045 | 0010 | 3 | Electric hook, switch or myoelectric controlled, pediatric | Pediatric electric hook |
L7170 | 0010 | 3 | Electronic elbow, hosmer or equal, switch controlled | Electronic elbow hosmer swit |
L7180 | 0010 | 3 | Electronic elbow, microprocessor sequential control of elbow and terminal device | Electronic elbow sequential |
L7181 | 0010 | 3 | Electronic elbow, microprocessor simultaneous control of elbow and terminal device | Electronic elbo simultaneous |
L7185 | 0010 | 3 | Electronic elbow, adolescent, variety village or equal, switch controlled | Electron elbow adolescent sw |
L7186 | 0010 | 3 | Electronic elbow, child, variety village or equal, switch controlled | Electron elbow child switch |
L7190 | 0010 | 3 | Electronic elbow, adolescent, variety village or equal, myoelectronically controlled | Elbow adolescent myoelectron |
L7191 | 0010 | 3 | Electronic elbow, child, variety village or equal, myoelectronically controlled | Elbow child myoelectronic ct |
L7259 | 0010 | 3 | Electronic wrist rotator, any type | Electronic wrist rotator any |
L7260 | 0010 | 3 | Electronic wrist rotator, otto bock or equal | Electron wrist rotator otto |
L7261 | 0010 | 3 | Electronic wrist rotator, for utah arm | Electron wrist rotator utah |
L7360 | 0010 | 3 | Six volt battery, each | Six volt bat otto bock/eq ea |
L7362 | 0010 | 3 | Battery charger, six volt, each | Battery chrgr six volt otto |
L7364 | 0010 | 3 | Twelve volt battery, each | Twelve volt battery utah/equ |
L7366 | 0010 | 3 | Battery charger, twelve volt, each | Battery chrgr 12 volt utah/e |
L7367 | 0010 | 3 | Lithium ion battery, rechargeable, replacement | Replacemnt lithium ionbatter |
L7368 | 0010 | 3 | Lithium ion battery charger, replacement only | Lithium ion battery charger |
L7400 | 0010 | 3 | Addition to upper extremity prosthesis, below elbow/wrist disarticulation, ultralight material (titanium, carbon fiber or equal) | Add ue prost be/wd, ultlite |
L7401 | 0010 | 3 | Addition to upper extremity prosthesis, above elbow disarticulation, ultralight material (titanium, carbon fiber or equal) | Add ue prost a/e ultlite mat |
L7402 | 0010 | 3 | Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, ultralight material (titanium, carbon fiber or equal) | Add ue prost s/d ultlite mat |
L7403 | 0010 | 3 | Addition to upper extremity prosthesis, below elbow/wrist disarticulation, acrylic material | Add ue prost b/e acrylic |
L7404 | 0010 | 3 | Addition to upper extremity prosthesis, above elbow disarticulation, acrylic material | Add ue prost a/e acrylic |
L7405 | 0010 | 3 | Addition to upper extremity prosthesis, shoulder disarticulation/interscapular thoracic, acrylic material | Add ue prost s/d acrylic |
L7499 | 0010 | 3 | Upper extremity prosthesis, not otherwise specified | Upper extremity prosthes nos |
L7510 | 0010 | 3 | Repair of prosthetic device, repair or replace minor parts | Prosthetic device repair rep |
L7520 | 0010 | 3 | Repair prosthetic device, labor component, per 15 minutes | Repair prosthesis per 15 min |
L7600 | 0010 | 3 | Prosthetic donning sleeve, any material, each | Prosthetic donning sleeve |
L7700 | 0010 | 3 | Gasket or seal, for use with prosthetic socket insert, any type, each | Pros soc insert gasket/seal |
L7900 | 0010 | 3 | Male vacuum erection system | Male vacuum erection system |
L7902 | 0010 | 3 | Tension ring, for vacuum erection device, any type, replacement only, each | Tension ring, vac erect dev |
L8000 | 0010 | 3 | Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type | Mastectomy bra |
L8001 | 0010 | 3 | Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, unilateral, any size, any type | Breast prosthesis bra & form |
L8002 | 0010 | 3 | Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type | Brst prsth bra & bilat form |
L8010 | 0010 | 3 | Breast prosthesis, mastectomy sleeve | Mastectomy sleeve |
L8015 | 0010 | 3 | External breast prosthesis garment, with mastectomy form, post mastectomy | Ext breastprosthesis garment |
L8020 | 0010 | 3 | Breast prosthesis, mastectomy form | Mastectomy form |
L8030 | 0010 | 3 | Breast prosthesis, silicone or equal, without integral adhesive | Breast prosthes w/o adhesive |
L8031 | 0010 | 3 | Breast prosthesis, silicone or equal, with integral adhesive | Breast prosthesis w adhesive |
L8032 | 0010 | 3 | Nipple prosthesis, prefabricated, reusable, any type, each | Reusable nipple prosthesis |
L8033 | 0010 | 3 | Nipple prosthesis, custom fabricated, reusable, any material, any type, each | Nipple prosthesis custom, ea |
L8035 | 0010 | 3 | Custom breast prosthesis, post mastectomy, molded to patient model | Custom breast prosthesis |
L8039 | 0010 | 3 | Breast prosthesis, not otherwise specified | Breast prosthesis nos |
L8040 | 0010 | 3 | Nasal prosthesis, provided by a non-physician | Nasal prosthesis |
L8041 | 0010 | 3 | Midfacial prosthesis, provided by a non-physician | Midfacial prosthesis |
L8042 | 0010 | 3 | Orbital prosthesis, provided by a non-physician | Orbital prosthesis |
L8043 | 0010 | 3 | Upper facial prosthesis, provided by a non-physician | Upper facial prosthesis |
L8044 | 0010 | 3 | Hemi-facial prosthesis, provided by a non-physician | Hemi-facial prosthesis |
L8045 | 0010 | 3 | Auricular prosthesis, provided by a non-physician | Auricular prosthesis |
L8046 | 0010 | 3 | Partial facial prosthesis, provided by a non-physician | Partial facial prosthesis |
L8047 | 0010 | 3 | Nasal septal prosthesis, provided by a non-physician | Nasal septal prosthesis |
L8048 | 0010 | 3 | Unspecified maxillofacial prosthesis, by report, provided by a non-physician | Unspec maxillofacial prosth |
L8049 | 0010 | 3 | Repair or modification of maxillofacial prosthesis, labor component, 15 minute increments, provided by a non-physician | Repair maxillofacial prosth |
L8300 | 0010 | 3 | Truss, single with standard pad | Truss single w/ standard pad |
L8310 | 0010 | 3 | Truss, double with standard pads | Truss double w/ standard pad |
L8320 | 0010 | 3 | Truss, addition to standard pad, water pad | Truss addition to std pad wa |
L8330 | 0010 | 3 | Truss, addition to standard pad, scrotal pad | Truss add to std pad scrotal |
L8400 | 0010 | 3 | Prosthetic sheath, below knee, each | Sheath below knee |
L8410 | 0010 | 3 | Prosthetic sheath, above knee, each | Sheath above knee |
L8415 | 0010 | 3 | Prosthetic sheath, upper limb, each | Sheath upper limb |
L8417 | 0010 | 3 | Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each | Pros sheath/sock w gel cushn |
L8420 | 0010 | 3 | Prosthetic sock, multiple ply, below knee, each | Prosthetic sock multi ply bk |
L8430 | 0010 | 3 | Prosthetic sock, multiple ply, above knee, each | Prosthetic sock multi ply ak |
L8435 | 0010 | 3 | Prosthetic sock, multiple ply, upper limb, each | Pros sock multi ply upper lm |
L8440 | 0010 | 3 | Prosthetic shrinker, below knee, each | Shrinker below knee |
L8460 | 0010 | 3 | Prosthetic shrinker, above knee, each | Shrinker above knee |
L8465 | 0010 | 3 | Prosthetic shrinker, upper limb, each | Shrinker upper limb |
L8470 | 0010 | 3 | Prosthetic sock, single ply, fitting, below knee, each | Pros sock single ply bk |
L8480 | 0010 | 3 | Prosthetic sock, single ply, fitting, above knee, each | Pros sock single ply ak |
L8485 | 0010 | 3 | Prosthetic sock, single ply, fitting, upper limb, each | Pros sock single ply upper l |
L8499 | 0010 | 3 | Unlisted procedure for miscellaneous prosthetic services | Unlisted misc prosthetic ser |
L8500 | 0010 | 3 | Artificial larynx, any type | Artificial larynx |
L8501 | 0010 | 3 | Tracheostomy speaking valve | Tracheostomy speaking valve |
L8505 | 0010 | 3 | Artificial larynx replacement battery / accessory, any type | Artificial larynx, accessory |
L8507 | 0010 | 3 | Tracheo-esophageal voice prosthesis, patient inserted, any type, each | Trach-esoph voice pros pt in |
L8509 | 0010 | 3 | Tracheo-esophageal voice prosthesis, inserted by a licensed health care provider, any type | Trach-esoph voice pros md in |
L8510 | 0010 | 3 | Voice amplifier | Voice amplifier |
L8511 | 0010 | 3 | Insert for indwelling tracheoesophageal prosthesis, with or without valve, replacement only, each | Indwelling trach insert |
L8512 | 0010 | 3 | Gelatin capsules or equivalent, for use with tracheoesophageal voice prosthesis, replacement only, per 10 | Gel cap for trach voice pros |
L8513 | 0010 | 3 | Cleaning device used with tracheoesophageal voice prosthesis, pipet, brush, or equal, replacement only, each | Trach pros cleaning device |
L8514 | 0010 | 3 | Tracheoesophageal puncture dilator, replacement only, each | Repl trach puncture dilator |
L8515 | 0010 | 3 | Gelatin capsule, application device for use with tracheoesophageal voice prosthesis, each | Gel cap app device for trach |
L8600 | 0010 | 3 | Implantable breast prosthesis, silicone or equal | Implant breast silicone/eq |
L8603 | 0010 | 3 | Injectable bulking agent, collagen implant, urinary tract, 2.5 ml syringe, includes shipping and necessary supplies | Collagen imp urinary 2.5 ml |
L8604 | 0010 | 3 | Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies | Dextranomer/hyaluronic acid |
L8605 | 0010 | 3 | Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, anal canal, 1 ml, includes shipping and necessary supplies | Inj bulking agent anal canal |
L8606 | 0010 | 3 | Injectable bulking agent, synthetic implant, urinary tract, 1 ml syringe, includes shipping and necessary supplies | Synthetic implnt urinary 1ml |
L8607 | 0010 | 3 | Injectable bulking agent for vocal cord medialization, 0.1 ml, includes shipping and necessary supplies | Inj vocal cord bulking agent |
L8608 | 0010 | 3 | Miscellaneous external component, supply or accessory for use with the argus ii retinal prosthesis system | Arg ii ext com/sup/acc misc |
L8609 | 0010 | 3 | Artificial cornea | Artificial cornea |
L8610 | 0010 | 3 | Ocular implant | Ocular implant |
L8612 | 0010 | 3 | Aqueous shunt | Aqueous shunt prosthesis |
L8613 | 0010 | 3 | Ossicula implant | Ossicular implant |
L8614 | 0010 | 3 | Cochlear device, includes all internal and external components | Cochlear device |
L8615 | 0010 | 3 | Headset/headpiece for use with cochlear implant device, replacement | Coch implant headset replace |
L8616 | 0010 | 3 | Microphone for use with cochlear implant device, replacement | Coch implant microphone repl |
L8617 | 0010 | 3 | Transmitting coil for use with cochlear implant device, replacement | Coch implant trans coil repl |
L8618 | 0010 | 3 | Transmitter cable for use with cochlear implant device or auditory osseointegrated device, replacement | Coch implant tran cable repl |
L8619 | 0010 | 3 | Cochlear implant, external speech processor and controller, integrated system, replacement | Coch imp ext proc/contr rplc |
L8621 | 0010 | 3 | Zinc air battery for use with cochlear implant device and auditory osseointegrated sound processors, replacement, each | Repl zinc air battery |
L8622 | 0010 | 3 | Alkaline battery for use with cochlear implant device, any size, replacement, each | Repl alkaline battery |
L8623 | 0010 | 3 | Lithium ion battery for use with cochlear implant device speech processor, other than ear level, replacement, each | Lith ion batt cid,non-earlvl |
L8624 | 0010 | 3 | Lithium ion battery for use with cochlear implant or auditory osseointegrated device speech processor, ear level, replacement, each | Lith ion batt cid, ear level |
L8625 | 0010 | 3 | External recharging system for battery for use with cochlear implant or auditory osseointegrated device, replacement only, each | Charger coch impl/aoi battry |
L8627 | 0010 | 3 | Cochlear implant, external speech processor, component, replacement | Cid ext speech process repl |
L8628 | 0010 | 3 | Cochlear implant, external controller component, replacement | Cid ext controller repl |
L8629 | 0010 | 3 | Transmitting coil and cable, integrated, for use with cochlear implant device, replacement | Cid transmit coil and cable |
L8630 | 0010 | 3 | Metacarpophalangeal joint implant | Metacarpophalangeal implant |
L8631 | 0010 | 3 | Metacarpal phalangeal joint replacement, two or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon), for surgical implantation (all sizes, includes entire system) | Mcp joint repl 2 pc or more |
L8641 | 0010 | 3 | Metatarsal joint implant | Metatarsal joint implant |
L8642 | 0010 | 3 | Hallux implant | Hallux implant |
L8658 | 0010 | 3 | Interphalangeal joint spacer, silicone or equal, each | Interphalangeal joint spacer |
L8659 | 0010 | 3 | Interphalangeal finger joint replacement, 2 or more pieces, metal (e.g., stainless steel or cobalt chrome), ceramic-like material (e.g., pyrocarbon) for surgical implantation, any size | Interphalangeal joint repl |
L8670 | 0010 | 3 | Vascular graft material, synthetic, implant | Vascular graft, synthetic |
L8679 | 0010 | 3 | Implantable neurostimulator, pulse generator, any type | Imp neurosti pls gn any type |
L8680 | 0010 | 3 | Implantable neurostimulator electrode, each | Implt neurostim elctr each |
L8681 | 0010 | 3 | Patient programmer (external) for use with implantable programmable neurostimulator pulse generator, replacement only | Pt prgrm for implt neurostim |
L8682 | 0010 | 3 | Implantable neurostimulator radiofrequency receiver | Implt neurostim radiofq rec |
L8683 | 0010 | 3 | Radiofrequency transmitter (external) for use with implantable neurostimulator radiofrequency receiver | Radiofq trsmtr for implt neu |
L8684 | 0010 | 3 | Radiofrequency transmitter (external) for use with implantable sacral root neurostimulator receiver for bowel and bladder management, replacement | Radiof trsmtr implt scrl neu |
L8685 | 0010 | 3 | Implantable neurostimulator pulse generator, single array, rechargeable, includes extension | Implt nrostm pls gen sng rec |
L8686 | 0010 | 3 | Implantable neurostimulator pulse generator, single array, non-rechargeable, includes extension | Implt nrostm pls gen sng non |
L8687 | 0010 | 3 | Implantable neurostimulator pulse generator, dual array, rechargeable, includes extension | Implt nrostm pls gen dua rec |
L8688 | 0010 | 3 | Implantable neurostimulator pulse generator, dual array, non-rechargeable, includes extension | Implt nrostm pls gen dua non |
L8689 | 0010 | 3 | External recharging system for battery (internal) for use with implantable neurostimulator, replacement only | External recharg sys intern |
L8690 | 0010 | 3 | Auditory osseointegrated device, includes all internal and external components | Aud osseo dev, int/ext comp |
L8691 | 0010 | 3 | Auditory osseointegrated device, external sound processor, excludes transducer/actuator, replacement only, each | Aoi snd proc repl excl actua |
L8692 | 0010 | 3 | Auditory osseointegrated device, external sound processor, used without osseointegration, body worn, includes headband or other means of external attachment | Non-osseointegrated snd proc |
L8693 | 0010 | 3 | Auditory osseointegrated device abutment, any length, replacement only | Aud osseo dev, abutment |
L8694 | 0010 | 3 | Auditory osseointegrated device, transducer/actuator, replacement only, each | Aoi transducer/actuator repl |
L8695 | 0010 | 3 | External recharging system for battery (external) for use with implantable neurostimulator, replacement only | External recharg sys extern |
L8696 | 0010 | 3 | Antenna (external) for use with implantable diaphragmatic/phrenic nerve stimulation device, replacement, each | Ext antenna phren nerve stim |
L8698 | 0010 | 3 | Miscellaneous component, supply or accessory for use with total artificial heart system | Misc used with tot art heart |
L8699 | 0010 | 3 | Prosthetic implant, not otherwise specified | Prosthetic implant nos |
L8701 | 0010 | 3 | Powered upper extremity range of motion assist device, elbow, wrist, hand with single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated | Pow ue rom dev ewh uprt cust |
L8702 | 0010 | 3 | Powered upper extremity range of motion assist device, elbow, wrist, hand, finger, single or double upright(s), includes microprocessor, sensors, all components and accessories, custom fabricated | Pow ue rom dev ewhf uprt cus |
L9900 | 0010 | 3 | Orthotic and prosthetic supply, accessory, and/or service component of another hcpcs “l” code | O&p supply/accessory/service |