L6883 |
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Replacement socket, below elbow/wrist disarticulation, molded to patient model, for use with or without external power
short | Replc sockt below e/w disa |
MUE | Location | Value | Ajudication Indicator | Rationale |
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PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | DME | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L6884 |
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Replacement socket, above elbow/elbow disarticulation, molded to patient model, for use with or without external power
short | Replc sockt above elbow disa |
MUE | Location | Value | Ajudication Indicator | Rationale |
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PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | DME | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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L6885 |
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Replacement socket, shoulder disarticulation/interscapular thoracic, molded to patient model, for use with or without external power
short | Replc sockt shldr dis/interc |
MUE | Location | Value | Ajudication Indicator | Rationale |
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PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | OPH | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration | DME | 2.0 | 2 Date of Service Edit: Policy | Anatomic Consideration |
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