Browse HCPCS Level II 2020 Edition

L5710 - L5780  Prosthetic Procedures - Additions to Exoskeletal Knee-Shin System

L5710 Addition, exoskeletal knee-shin system, single axis, manual lock short Kne-shin exo sng axi mnl loc MUE Location Value Ajudication Indicator Rationale 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

L5711 Additions exoskeletal knee-shin system, single axis, manual lock, ultra-light material short Knee-shin exo mnl lock ultra MUE Location Value Ajudication Indicator Rationale 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

L5712 Addition, exoskeletal knee-shin system, single axis, friction swing and stance phase control (safety knee) short Knee-shin exo frict swg & st MUE Location Value Ajudication Indicator Rationale 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

L5714 Addition, exoskeletal knee-shin system, single axis, variable friction swing phase control short Knee-shin exo variable frict MUE Location Value Ajudication Indicator Rationale 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

L5716 Addition, exoskeletal knee-shin system, polycentric, mechanical stance phase lock short Knee-shin exo mech stance ph MUE Location Value Ajudication Indicator Rationale 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

L5718 Addition, exoskeletal knee-shin system, polycentric, friction swing and stance phase control short Knee-shin exo frct swg & sta MUE Location Value Ajudication Indicator Rationale 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

L5722 Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control short Knee-shin pneum swg frct exo MUE Location Value Ajudication Indicator Rationale 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

L5724 Addition, exoskeletal knee-shin system, single axis, fluid swing phase control short Knee-shin exo fluid swing ph MUE Location Value Ajudication Indicator Rationale 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

L5726 Addition, exoskeletal knee-shin system, single axis, external joints fluid swing phase control short Knee-shin ext jnts fld swg e MUE Location Value Ajudication Indicator Rationale 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

L5728 Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control short Knee-shin fluid swg & stance MUE Location Value Ajudication Indicator Rationale 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

L5780 Addition, exoskeletal knee-shin system, single axis, pneumatic/hydra pneumatic swing phase control short Knee-shin pneum/hydra pneum MUE Location Value Ajudication Indicator Rationale 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