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L6055 |
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Wrist disarticulation, molded socket with expandable interface, flexible elbow hinges, triceps pad
| short | Wrst mold sock w/exp interfa |
| 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 |
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