L6400 |
|
Below elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
short | Below elbow prosth tiss shap |
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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|
|
L6450 |
|
Elbow disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
short | Elb disart prosth tiss shap |
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 |
|
|
|
L6500 |
|
Above elbow, molded socket, endoskeletal system, including soft prosthetic tissue shaping
short | Above elbow prosth tiss shap |
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 |
|
|
|
L6550 |
|
Shoulder disarticulation, molded socket, endoskeletal system, including soft prosthetic tissue shaping
short | Shldr disar prosth tiss shap |
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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|
|
L6570 |
|
Interscapular thoracic, molded socket, endoskeletal system, including soft prosthetic tissue shaping
short | Scap thorac prosth tiss shap |
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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|
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