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L5668 - Bk molded distal cushion

Navigation: HCPCS Codes > Codes with Prefix: L5
Field Value
HCPCS Code: L5668
Long Description: Addition to lower extremity, below knee, molded distal cushion
Short Description: Bk molded distal cushion
Pricing Indicator 1: 38 (Orthotics, prosthetics, prosthetic devices & vision services (price subject to floors and ceilings))
Multiple Pricing Code: A (Not applicable as HCPCS priced under one methodology)
Statute Number:
Coverage Code: C (Carrier judgment)
ASC Payment Group Code:
Processing Note Number:
Berenson-Eggers Type of Service (BETOS) Code: D1F (Orthotic devices)
Type of Service Code 1: P (Lump sum purchase of DME, prosthetics, orthotics)
Anesthesia Base Unit Quality: 0
Code Added: 01-01-1986
Action Effective Date: 01-01-2014
Action Code: S (Change in short description of procedure code)