Showing codes L5666 (Addition to lower extremity, below knee, cuff suspension) — L5704 (Custom shaped protective cover, below knee)

L5666 - Below knee cuff suspension
Long description: Addition to lower extremity, below knee, cuff suspension
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5668 - Bk molded distal cushion
Long description: Addition to lower extremity, below knee, molded distal cushion
Code added date: 19860101.
Code effective date: 20140101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5670 - Bk molded supracondylar susp
Long description: Addition to lower extremity, below knee, molded supracondylar suspension ('pts' or similar)
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5671 - Bk/ak locking mechanism
Long description: Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert
Code added date: 20020101.
Code effective date: 20020101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5672 - Bk removable medial brim sus
Long description: Addition to lower extremity, below knee, removable medial brim suspension
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5673 - Socket insert w lock mech
Long description: 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
Code added date: 20040101.
Code effective date: 20040101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5676 - Bk knee joints single axis p
Long description: Additions to lower extremity, below knee, knee joints, single axis, pair
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5677 - Bk knee joints polycentric p
Long description: Additions to lower extremity, below knee, knee joints, polycentric, pair
Code added date: 19880101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5678 - Bk joint covers pair
Long description: Additions to lower extremity, below knee, joint covers, pair
Code added date: 19840101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5679 - Socket insert w/o lock mech
Long description: 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
Code added date: 20040101.
Code effective date: 20040101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5680 - Bk thigh lacer non-molded
Long description: Addition to lower extremity, below knee, thigh lacer, nonmolded
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5681 - Intl custm cong/latyp insert
Long description: Addition to lower extremity, below knee/above knee, custom fabricated socket insert for congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)
Code added date: 20040101.
Code effective date: 20040101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5682 - Bk thigh lacer glut/ischia m
Long description: Addition to lower extremity, below knee, thigh lacer, gluteal/ischial, molded
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5683 - Initial custom socket insert
Long description: Addition to lower extremity, below knee/above knee, custom fabricated socket insert for other than congenital or atypical traumatic amputee, silicone gel, elastomeric or equal, for use with or without locking mechanism, initial only (for other than initial, use code l5673 or l5679)
Code added date: 20040101.
Code effective date: 20040101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5684 - Bk fork strap
Long description: Addition to lower extremity, below knee, fork strap
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5685 - Below knee sus/seal sleeve
Long description: Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each
Code added date: 20050101.
Code effective date: 20050101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5686 - Bk back check
Long description: Addition to lower extremity, below knee, back check (extension control)
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5688 - Bk waist belt webbing
Long description: Addition to lower extremity, below knee, waist belt, webbing
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5690 - Bk waist belt padded and lin
Long description: Addition to lower extremity, below knee, waist belt, padded and lined
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5692 - Ak pelvic control belt light
Long description: Addition to lower extremity, above knee, pelvic control belt, light
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5694 - Ak pelvic control belt pad/l
Long description: Addition to lower extremity, above knee, pelvic control belt, padded and lined
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5695 - Ak sleeve susp neoprene/equa
Long description: Addition to lower extremity, above knee, pelvic control, sleeve suspension, neoprene or equal, each
Code added date: 19890101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5696 - Ak/knee disartic pelvic join
Long description: Addition to lower extremity, above knee or knee disarticulation, pelvic joint
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5697 - Ak/knee disartic pelvic band
Long description: Addition to lower extremity, above knee or knee disarticulation, pelvic band
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5698 - Ak/knee disartic silesian ba
Long description: Addition to lower extremity, above knee or knee disarticulation, silesian bandage
Code added date: 19860101.
Code effective date: 19860101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5699 - Shoulder harness
Long description: All lower extremity prostheses, shoulder harness
Code added date: 19860101.
Code effective date: 19960101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5700 - Replace socket below knee
Long description: Replacement, socket, below knee, molded to patient model
Code added date: 19940101.
Code effective date: 19940101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5701 - Replace socket above knee
Long description: Replacement, socket, above knee/knee disarticulation, including attachment plate, molded to patient model
Code added date: 19940101.
Code effective date: 19940101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5702 - Replace socket hip
Long description: Replacement, socket, hip disarticulation, including hip joint, molded to patient model
Code added date: 19940101.
Code effective date: 19940101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5703 - Symes ankle w/o (sach) foot
Long description: Ankle, symes, molded to patient model, socket without solid ankle cushion heel (sach) foot, replacement only
Code added date: 20060101.
Code effective date: 20060101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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L5704 - Custom shape cover bk
Long description: Custom shaped protective cover, below knee
Code added date: 19940101.
Code effective date: 20020101.
Pricing Indicator Code(s): 38 ; (Codes used to identify the appropriate methodology for developing unique pricing amounts under part B. A procedure may have one to four pricing codes.)
Coverage Code: C (A code denoting Medicare coverage status).
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