Table of content for "Socket insert below knee" (HCPCS L5655)
General information on the “L5655” code
HCPCS Code: L5655
Long Description: Addition to lower extremity, socket insert, below knee (kemblo, pelite, aliplast, plastazote or equal)
Short Description: Socket insert below knee
Original information is taken from L5655 page
Pricing indicators
Pricing Indicator Code 1: 38 – Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings) . Durable Medical Equipment, Prosthetics, Orthotics, Supplies And Surgical Dressings
Multiple Pricing Indicator Code A : Not applicable as HCPCS priced under one methodology
Certification and additional reference information
Coverage
Coverage: C – Carrier judgment
Type of service
Berenson-Eggers Type of Service (BETOS): D1F – Prosthetic/Orthotic devices
Type Of Service 1: P – Lump sum purchase of DME, prosthetics, orthotics
Misc information
Anesthesia Base Unit Quantity: 0
Code Added Date: 19860101
Code Effective Date: 19860101
Action Code: N – No maintenance for this code