Browse HCPCS Level II 2020 Edition

L8400 - L8499  Prosthetic Procedures - Prosthetic Socks

L8400 Prosthetic sheath, below knee, each short Sheath below knee MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: Data DME 12.0 3 Date of Service Edit: Clinical Clinical: Data

L8410 Prosthetic sheath, above knee, each short Sheath above knee MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup DME 12.0 3 Date of Service Edit: Clinical Clinical: Data

L8415 Prosthetic sheath, upper limb, each short Sheath upper limb MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 6.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup DME 6.0 3 Date of Service Edit: Clinical Clinical: Data

L8417 Prosthetic sheath/sock, including a gel cushion layer, below knee or above knee, each short Pros sheath/sock w gel cushn MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: Data DME 12.0 3 Date of Service Edit: Clinical Clinical: Data

L8420 Prosthetic sock, multiple ply, below knee, each short Prosthetic sock multi ply bk MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 14.0 3 Date of Service Edit: Clinical Clinical: Data DME 24.0 3 Date of Service Edit: Clinical Clinical: Data

L8430 Prosthetic sock, multiple ply, above knee, each short Prosthetic sock multi ply ak MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: Data DME 24.0 3 Date of Service Edit: Clinical Clinical: Data

L8435 Prosthetic sock, multiple ply, upper limb, each short Pros sock multi ply upper lm MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup DME 12.0 3 Date of Service Edit: Clinical Clinical: Data

L8440 Prosthetic shrinker, below knee, each short Shrinker below knee MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 4.0 3 Date of Service Edit: Clinical Clinical: Data DME 4.0 3 Date of Service Edit: Clinical Clinical: Data

L8460 Prosthetic shrinker, above knee, each short Shrinker above knee MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 4.0 3 Date of Service Edit: Clinical Clinical: Data DME 4.0 3 Date of Service Edit: Clinical Clinical: Data

L8465 Prosthetic shrinker, upper limb, each short Shrinker upper limb MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 4.0 3 Date of Service Edit: Clinical Clinical: Data DME 4.0 3 Date of Service Edit: Clinical Clinical: Data

L8470 Prosthetic sock, single ply, fitting, below knee, each short Pros sock single ply bk MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 14.0 3 Date of Service Edit: Clinical Clinical: Data DME 24.0 3 Date of Service Edit: Clinical Clinical: Data

L8480 Prosthetic sock, single ply, fitting, above knee, each short Pros sock single ply ak MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: Data DME 24.0 3 Date of Service Edit: Clinical Clinical: Data

L8485 Prosthetic sock, single ply, fitting, upper limb, each short Pros sock single ply upper l MUE Location Value Ajudication Indicator Rationale PRA 0.0 3 Date of Service Edit: Clinical CMS Policy OPH 12.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup DME 12.0 3 Date of Service Edit: Clinical Clinical: Data

L8499 Unlisted procedure for miscellaneous prosthetic services short Unlisted misc prosthetic ser MUE Location Value Ajudication Indicator Rationale PRA 1.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup OPH 1.0 3 Date of Service Edit: Clinical Clinical: CMS Workgroup